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Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension

  • Director of Anatomic Pathology Development

In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, CMS has instructed the Medicare Administrative Contractors (MACs) to temporarily hold all claims with dates of service on or after April 1, 2021. Per CMS’s announcement, this is intended to only take place for a short period of time and should not have any significant impact to providers’ cash flow.

Without a hold in place, Medicare claims would be processed with the 2% reduction automatically. CMS’s requests to hold claims reduces the risk of claims being processed at the incorrect rate, further saving efforts on reprocessing high volumes of claims should the extension be confirmed and current rates are restored.

CMS has confirmed that the MACs will automatically reprocess any claims paid with the reduction applied, if necessary.

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