HomeLatest NewsFederal NewsBilling Edits for OPPS Providers with Multiple Service Locations Delayed

Billing Edits for OPPS Providers with Multiple Service Locations Delayed

The Centers for Medicare & Medicaid Services (CMS) has postponed billing edits for outpatient providers with multiple service locations — scheduled to start in April — for three additional months.

CMS has delayed full implementation of the edits to allow providers time to adjust to a new Provider Enrollment, Chain and Ownership System (PECOS) practice location screen. The screen will be available for providers to check in the April quarterly release. Additional testing will occur in June to ensure providers have used the tool and made any necessary claims submission updates. Once CMS implements the July 2019 quarterly release, Medicare administrative contractors will be directed to permanently turn on edits and return claims that do not exactly match.

SDAHO reminds members that Medicare systems must validate the service facility location to ensure services are being provided in a Medicare-enrolled location. This validation will be exact matching based on the information submitted on the Form CMS-855A submitted by the provider and entered into PECOS. Providers need to ensure that the claims data match their provider enrollment information.​

Stay Connected

Unified Voice Newsletter

Events This Month

december

05dec12:00 pm1:00 pmBecoming the Employer of Choice - How Organizations Create "Stickiness" for their WorkersSDAHO Webinar

05dec12:00 pm1:00 pmRural Hospital Growth Is Possible: How Expanding Critical Services Can Drive ResultsAHA Webinar

06dec1:00 pm2:00 pmSubstance Misuse Prevention Strategies to Improve Public Health: A Focus on State PracticesODPHP Webinar

06dec1:30 pm2:30 pmMedical Complexities of Chronic Opioid UseHazelden Betty Ford Webinar

07dec11:30 am12:45 pmFacility Safety and Security in Health CareAHA Webinar


By submitting this form, you are consenting to receive marketing emails from: . You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact