The Centers for Medicare & Medicaid Services (CMS) in July will begin enforcing a requirement that hospitals with multiple service locations accurately enter the service facility address of their off-campus, provider-based departments. The addresses will have to exactly match CMS records for the hospital to receive payment through the Outpatient Prospective Payment System (OPPS).
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 will continue tests of the requirement in June and, beginning in July, will direct Medicare administrative contractors to return claims to the provider if addresses are not an exact match.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.