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MLN Matters Article (New) MM12896: Patient Driven Payment Model: Claim Edit Enhancements

This revised Article comprises Subregulatory Guidance for corrections to edits of SNF Type of Bill (TOB) 21X claims and changes to certain hospital overlap edits. MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR12896 that is posted on the CMS website at https://www.cms.gov/files/document/r11879OTN.pdf.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 02, 2023

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.