2015 Medicare Claims to be Placed on Temporary Hold

Date: December 31, 2014

All Medicare Administrative Contractors (MAC) have removed the originally-posted 2015 Calendar Year (CY) Medicare fee schedules from their websites.  Some MACs have already posted that claims processing will be delayed 14 days “due to technical errors” found in the release of the original fee schedule.

Noridian’s website on this subject contains the following information:

  • In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2015 services paid under the MPFS for the first 14 calendar days of January 2015 (i.e., Thursday January 1 through Wednesday January 14).
  • The hold should have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

Importantly, claims with 2014 dates of service are unaffected – even if submitted in CY 2015.  Noridian notes:

  • MPFS claims for services rendered on or before Wednesday Dec 31, 2014 are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames.

We anticipate all other MAC will have the same information as noted above within a day or two.

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