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Title
What’s the Comprehensive Error Rate Testing (CERT) Program?
Date
2022-01-26
CMS created the CERT program to measure the error rate of improper Fee-for-Service payments. The error rate measures payments that didn’t meet Medicare requirements; it doesn’t indicate fraud.
How does the CERT program work?
The CERT contractor reviews a sample of processed claims. If a claim doesn’t meet Medicare’s coverage, coding, and billing rules or the provider fails to submit medical records, it’s counted as a total or partial improper payment. Medicare Administrative Contractors analyze CERT error rates to reduce improper payments by updating their internal processes and educating providers.