FQHC Claim Hold Effective DOS 1/1/2025
Date Reported:
01/03/2025
Status:
Open
Provider Types Impacted:
Part A FQHCs in Jurisdiction K and Jurisdiction 6
Reason Code(s):
N/A
Claim Coding Impact:
N/A
Description of Issue
CMS has issued claim hold instructions to all MACs, due to release and testing of a new FQHC pricer.
National Government Services Action
As per CMS instruction, NGS will apply condition code 15 to held claims so timeliness will not be impacted.
Provider Action
No provider action is indicated. Please continue to monitor this site for further updates.
Proposed Resolution/Fix
FQHC pricer deployment is anticipated to be completed in January, 2025.