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California Society of Pathologists
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Fax :  916-444-7462

No Medicare SGR Fix So Medicare Will Hold Claims on March 1st

Congress has not passed a fix to the SGR triggered reduction in physician fees that would take effect on March 1, 2010. CMS released the statement printed below. There is normally a 14 day hold on payment of claims so nothing is really changing in terms of timing.


The Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule. As you are aware, the Department of Defense Appropriations Act of 2010 provided a zero percent (0%) update to the 2010 MPFS effective for dates of service January 1, 2010, through February 28, 2010. 


We believe Congress is working to avoid the negative update that will take effect March 1.  Consequently, CMS has instructed its contractors to hold claims containing services paid under the MPFS for the first 10 business days of March. The holding of MPFS claims will only affect claims with dates of service March 1, 2010, and forward.  This hold should have a minimum impact on provider cash flow because, under current law, clean electronic claims are not paid any sooner than 14 calendar days (29 for paper claims) after the date of receipt.  Be on the alert for more information about the 2010 Medicare Physician Fee Schedule Update.