It has been brought to the attention of the Centers for Medicare & Medicaid Services (CMS) that the Fiscal Intermediary Shared System (FISS) is taking the Multiple Procedure Payment Reduction on claims regardless of whether the services were provided on the same day. As a result of this coding error, any therapy claims with dates of service on or after January 1, 2011, processed from January 3, 2011 through February 6, 2011, with one of the specified therapy codes in Change Request (CR) 7050 were processed incorrectly.
System changes were successfully implemented on February 7, 2001, and the CMS has instructed Medicare contractors to adjust claims that processed incorrectly. CMS has also learned that the FISS was using a rate file which contains rates that reflect a 20% reduction rather than the 25% reduction that is appropriate for institutional claims. As a result of this error, all therapy services subject to the MPPR with dates of service on or after January 1, 2011, have been paid incorrect amounts. Medicare contractors will install a corrected rate file in early May, and the CMS has instructed Medicare contractors to adjust claims that were paid incorrectly no later than June 30, 2011. Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to (http://www.cms.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Listservs.pdf). If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/ContactCMS). Thank you.
