This week, CMS released guidance indicating that they will fully implement “exact match” requirements on August 1, 2023. The agency has instructed MACs to develop plans to permanently turn on the Reason Codes and set them up to RTP claims that don’t exactly match. MACs will be providing further notice of how they plan to execute “exact match.”
Initially slated for implementation in 2019, CMS delayed implementation of “exact match” requirements to April 2020, and then indefinitely at the onset of the pandemic in March 2020. Now that the PHE has ended, CMS is turning its attention to the rule, which requires hospitals to include the actual service facility address for certain hospital outpatient departments and remote inpatient locations in Loop 2310E of the 837I electronic institutional claims transaction. Per the rule, these addresses must exactly match an address registered on the hospital’s Medicare 855A enrollment record. Additional information on the rule can be found here.
Advis recommends a complete review of Medicare enrollment and billing records to ensure your organization is ready for CMS’s implementation of “exact match” requirements in August. For more information on these requirements, or for assistance with implementation and/or review of your processes, contact our office at (708) 478-7030.
Published: July 13, 2023