Compliance: CMS Reports Slight Error Rate Decrease For 2023

Why This Topic Matters

CERT findings help providers and revenue cycle teams understand where Medicare claim vulnerability is increasing or improving. The article is useful for identifying broad compliance areas that may warrant documentation review, internal audits, or education.

Article Sections

1. Context and CERT overview

   Introduces the CMS report and explains the CERT program at a high level, including its role in measuring improper payments and claims compliance.

2. Check Out the Latest Statistics

   Summarizes the overall FY 2023 Medicare FFS improper payment results and compares them with the prior year across major payment categories.

3. E/M Visits for Established Patients Continue to Plague Part B Providers

   Discusses the leading causes behind improper payments, with emphasis on documentation, medical necessity, and evaluation and management claim issues.

4. Find Out If Your State Is an Outlier

   Describes the report’s state-level comparisons and how geographic variation is presented within the CERT findings.