BC Advantage - 2025 Issue 10
Medicare Has Revised Its Ten-Day Claims Hold Due to the Government Shutdown
When the federal government shutdown began on October 1, 2025, the Centers for Medicare and Medicaid Services (CMS) directed all Medicare Administrative Contractors (MACs) to implement a temporary claims hold of up to 10 business days to ensure that Medicare payments would be accurate and consistent with statutory requirements. CMS has now revised its instructions to limit the claims hold only to those “services impacted by the expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025.” The Act referenced by CMS is the source of the extension of the telehealth...
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