ED Coding & Reimbursement Alert - 2021 Issue 3
Compliance: CERT Shows Part B Error Rate Spiked in FY 2020
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Article Overview
This article explains the CMS Comprehensive Error Rate Testing (CERT) findings for FY 2020 and why the report matters for Medicare fee-for-service compliance. It focuses on Part B improper payment trends, the main documentation-related issue categories identified in the supplemental data, state-level statistics, and how CERT activities were affected by the COVID-19 public health emergency. The piece is intended for providers, coders, auditors, and compliance staff who monitor Medicare billing accuracy and medical necessity documentation.
Why This Topic Matters
CERT results help Medicare providers understand where claim errors are occurring and what documentation weaknesses are most commonly associated with improper payments. Reviewing these findings can help practices focus compliance and documentation improvement efforts.
What You Will Learn
- What the CMS CERT program is designed to measure
- How FY 2020 Medicare fee-for-service improper payment data is presented
- Which broad documentation issues were highlighted for Medicare Part B
- How state-level improper payment statistics are summarized
- How the COVID-19 public health emergency affected CERT review activity
Who Should Read This
- Physicians
- Medical coders
- Compliance officers
- Billing staff
- Auditors
- Practice managers
- Revenue cycle professionals
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