Medicare Fee-for-Service Claims and the Sequestration Payment Adjustment Changes
Just a reminder: The Protecting Medicare and American Farmers from Sequester Cuts Act impacts payments for all Medicare fee-for-service claims. As a result of this Act, a suspension on the sequestration was put in place due to the PHE. The sequestration was suspended through 3/31/2022.
Effective 4/1/2022, the 1% sequestration payment adjustment will be applied for claims with dates of services 4/1/2022–6/30/2022.
Of note, the sequestration payment adjustment will revert to the 2% rate for claims with dates of services as of 7/1/2022. This will bring the total sequestration rate to 2%, which was the rate in effect prior to the PHE.
The sequestration payment adjustment decrease will appear on the RA with a CARC 253, used to report the sequestration reduction. The code will appear as a CO 253 on the RA "Sequestration – reduction in federal payment" as the reason.
Revised 8/10/2023