CHA News Article

CMS Announces Mass Adjustment of Some OPPS Claims
Will issue corrected payments

The Centers for Medicare & Medicaid Services (CMS) has notified providers that Medicare administrative contractors will be making a mass adjustment to certain outpatient prospective payment system (OPPS) claims and issuing corrected payments. The claims affected are for ambulatory payment classification 1448 (ophthalmic mitoymycin). The national unadjusted copayment for these claims was set to 20 percent when it should have been $0 for claims with dates of service from Jan. 1, 2014, through the installation of the April 2015 OPPS pricer. CMS has corrected the error in the April 2015 OPPS pricer, as well as in OPPS addendums A and B. Providers will be responsible for reimbursing beneficiaries for any overpayment due to the erroneous copayment.