Part B Payments: Reprocessed Claims From Last Year Are Headed Your Way Soon, CMS Reps Say

Why This Topic Matters

The article helps practices track CMS payment corrections and understand forum guidance that may affect claim adjustment timing, annual wellness visit administration, refund obligations, and payment identification on remittance records.

Article Sections

1. Reprocessing of prior-year Medicare Part B claims

   Explains that CMS is reprocessing certain previously paid claims and describes the general timing and sequencing of those adjustments. The discussion focuses on how practices may receive corrected payments through Medicare administrative contractors.

2. Who Can Perform AWV?

   Discusses CMS forum comments about who may furnish annual wellness visits and notes that the agency advised caution pending written clarification. The section also references outside payer guidance on the same topic.

3. You Must Pay Your MAC Back for Incorrectly Collected Copays

   Covers CMS guidance on handling coinsurance or deductible amounts that were collected in connection with annual wellness visits. The section addresses refund responsibility when payment collection was inconsistent with Medicare policy.

4. Primary Care Incentive Payments Will Be Identified

   Describes how primary care incentive payments may be labeled or reflected on payment and remittance information. The section focuses on payment identification and reporting rather than coding details.