Medicare Errors: E/M Factors Largely in Part B's 2015 Fee-For-Service Error Rate

Why This Topic Matters

The piece helps readers understand where Medicare improper payments were concentrated in 2015 and why E/M services continued to draw attention in Part B auditing. It is useful for organizations assessing documentation, coding, and compliance risk in Medicare claims.

Article Sections

1. Background

   Summarizes the CERT report context, the claim universe reviewed, and the broad categories of payment errors identified by auditors.

2. Five Measures That Helped

   Outlines broad CMS and program integrity actions discussed in relation to reducing improper payments in future years.

3. Stats and details

   Presents the overall payment error rates across major Medicare payment categories and the associated national totals.

4. Part B Struggles Are Real

   Focuses on documentation-driven errors within Part B and explains why these issues continued to be prominent in the report.

5. Watch your E/M services’ claims

   Reviews the article’s discussion of E/M service error patterns, common claim weaknesses, and affected practice areas.

6. Coding blunders

   Covers E/M-related coding and documentation concerns involving shared care, provider identifiers, and hospital visit settings.

7. Texas and Georgia Have the Highest Improper Payment Rates

   Lists the states highlighted for having the highest improper payment rates in the report.