Providers can elect to request Permanent Immediate Recoupment/Offset of their demanded overpayments to avoid making payment by check or avoid the assessment of interest if the immediate recoupment pays the debt in full before day 31. Medicare interest on debt payments accrues monthly rather than daily, debt payments paid on or after day 31 accrues interest for the entire following month at the treasury rate. The treasury rate currently charged by CMS is 10.125 percent. Providers who activate Permanent Immediate Recoupment/Offset generally have their debts offset and recouped on day 16. These payments are considered on-time payments and a great way to avoid interest accrual. This option is a one-time request that will allow your organization to immediately begin saving money in interest on Medicare debts. With Permanent Immediate Recoupment/Offset, the overpayment amount is deducted from upcoming Medicare payments. The recoupment does not begin until the 16th day from the date of the demand letter, so there is time to file an appeal if you disagree with the overpayment decision. You will have 120 days from the date of the demand letter to file an appeal even when recoupment/offset has occurred.