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

Issue Date: September 17, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: What payment code will issuers use for Federally-facilitated Small Business Health Options Program (FF-SHOP) payment amounts carried over to the next payment period?

Answer: The FF-SHOP does not carry forward payment amounts in an 820. The Centers for Medicare and Medicaid Services (CMS) would carry forward negative amounts. CMS and issuer internal systems will see these negative amounts applied as off-setting positive amounts on a future 820 transaction when a positive balance exists.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

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.