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

Issue Date: September 11, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: Does the Centers for Medicare and Medicaid Services (CMS) plan to use payment codes for Advanced Premium Tax Credit (APTC), Cost Sharing Reduction (CSR), Federally Facilitated Marketplace (FFM) User Fees, or Retroactive Adjustments, in the Federally-Facilitated Small Business Health Options Program (FF-SHOP) 820 Files in addition to the six SHOP specific payment codes?

Answer: FF-SHOP 820 files will only include the six SHOP-specific payment codes as SHOP does not make APTC, CSR, or FFM User Fee related-payments.

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