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CMS Delays Exact Match Requirement Implementation

The Centers for Medicare & Medicaid Services (CMS) delayed to April 2020 implementation and enforcement of a requirement that hospitals with multiple service locations accurately enter the service facility address of their off-campus, provider-based departments when filing Medicare claims. The addresses must exactly match CMS records for the hospital to receive payment through the Outpatient Prospective Payment System.

CMS began testing this requirement in July 2018 and found that many hospitals did not send the exact service facility location that matched a Medicare-enrolled location for off-campus, provider-based departments. Common errors included abbreviations, such as spelling out “Road” instead of using “Rd.”

CMS initially planned to implement the requirement beginning in July but subsequently pushed back the date twice, including the most recent delay to April 2020.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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