Dynamic List Information
Dynamic List Data
Transmittal #
R11488OTN
Issue Date
2022-07-07
Subject
New Edit for Prospective Payment System (PPS) Outpatient and Inpatient Bill Types Receiving an Outlier Payment When a Device Credit is Reported
Implementation Date
2023-01-03
CR #
12769
Provider Education
MLN Connects Newsletter Message
Provider Education Release Date
2022-07-14
Publication #
100-20
Transmittal Year
2022
MLN Connects® Newsletter Message
New Edit for Prospective Payment System (PPS) Outpatient and Inpatient Bill Types Receiving an Outlier Payment When a Device Credit is Reported
Effective January 1, 2023, CMS will suspend outpatient and inpatient prospective payment system claims getting an outlier payment when a device credit is reported. This will allow Medicare Administrative Contractors (MACs) to review the charges and device reduction amounts for fully or partially credited devices. There’s no policy change.
See the instruction to your MAC (PDF).