Production Alert Details

Reimbursing Place of Service 10 at the Nonfacility Rate for Medicare Telehealth Services

Date Reported:
02/22/2024
Date Updated:
04/02/2024
Date Resolved:
04/04/2024
Status:
Closed
Provider Types Impacted:

Part B providers in Jurisdiction 6 and Jurisdiction K

Reason Code(s):
N/A
Claim Coding Impact:
Part B telehealth service claims billed with POS 10

Description of Issue

In CY 2024, CMS issued a change to processing for telehealth services billed with POS 10. As of 1/1/2024, these claims are to be paid at the nonfacility PFS rate. A system processing issue resulted in incorrect payments at the facility rate and this issue has now been corrected. As per CMS instructions issued 2/21/2024, NGS will initiate a mass adjustment of all impacted claims with dates of service 1/1/2024 and after.

National Government Services Action

NGS will initiate a mass adjustment of all impacted claims with dates of service 1/1/2024 and after. Adjustments completed on 4/4/2024.

Provider Action

No provider action is necessary at this time.

Proposed Resolution/Fix

Mass adjustment of all impacted claims completed on 4/4/2024.

Update 4/2/2024: NGS expected date for mass adjustments on effected claims is 4/8/2024. Please continue to monitor this site for additional updates.

Update 3/6/2024: CMS advised NGS of a delay in the system correction for this issue and the associated mass adjustment. Please continue to monitor this site for additional updates.