Medicare Compliance & Reimbursement

If you thought that the Centers for Medicare & Medicaid Services (CMS) would nix its plans to reinstate the 2 percent sequestration payment adjustment on July 1, think again.

Reminder: During the pandemic, the sequestration payment adjustment was suspended, but the Protecting Medicare and American Farmers from Sequester Cuts Act ended that starting March 31, 2022. On April 1, the 1 percent sequestration payment adjustment was applied for claims with dates of services between April 1 and June 30, 2022, Part B Medicare Administrative Contractor (MAC) NGS indicates in a release.

Starting on July 1, “the sequestration payment adjustment will revert to the 2 percent rate for claims” which is what it was prior to the COVID-19 public health emergency (PHE), NGS says. “The sequestration payment adjustment decrease will appear on the RA with a CARC 253, used to report the sequestration reduction. The code will appear as a CO 253 on the RA ‘Sequestration – reduction in federal payment’ as the reason.”