MACs instructed to hold claims amid sequestration freeze

April 2, 2021

As expected, CMS announced MACs are being instructed to hold all claims with dates of service of April 1 or later in anticipation of Congress extending the 2% sequestration suspension for the remainder of 2021.

While the bill to extend the suspension has already passed the Senate, the House is not expected to take up the issue until after it returns from Easter break in mid-April. CMS also clarified any claims paid with the reduction will be automatically reprocessed. 

Prior to the bill’s passage, the sequestration cut was set to resume April 1 after having been suspended for the duration of the Covid-19 Public Health Emergency. Several advocacy groups, including the College of American Pathologists (CAP) and American Hospital Association (AHA), lobbied for the cut to be suspended for the remainder of 2021 due to the ongoing PHE.

While the Senate bill extends the Medicare sequester moratorium, it does not include a provision included in the earlier version passed by the House that would also stop additional sequestration cuts created by most recent Covid relief package, The American Rescue Plan.

Who's reviewing revenue strategy with you at this time?

Are you billing all the correct CPT codes? You’d be surprised at what you might be missing. We will review your Fee Schedule/Charge Master at no cost.

That’s right. For free.

Share This