The Centers for Medicare & Medicaid Services (CMS) recently instructed all Medicare Administrative Contractors (MACs) to lift the hold and begin processing fee-for-service claims dated Oct. 1 and after. The action follows the hold on services impacted by select expired Medicare legislative payment provisions, including those paid under the Medicare physician fee schedule, ground ambulance transport claims and Federally Qualified Health Center claims.
The updated guidance also instructs MACs to process telehealth claims that the CMS can confirm are for behavioral and mental health services. The CMS directed all MACs to continue holding claims for other telehealth services (non-behavioral/mental health claims) due to the Sept. 30 expiration of telehealth flexibilities put in place during the COVID-19 public health emergency and for the acute Hospital Care at Home Program, which also expired Sept. 30.
CMS also released an updated FAQ document Oct. 15 to provide additional guidance to providers.
Members with questions may contact Vickie Kunz at the MHA.