Activation of Systematic Validation Edits for OPPS Providers with Multiple Service Locations - Update
This revised Special Edition Article (SE) comprises Subregulatory Guidance for enforcing the systematic validation edits requirements in Section 170 of Chapter 1: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c01.pdf. These aren’t new requirements. CMS discussed these requirements in CRs 9613 and 9907, effective January 1, 2017. On March 24, 2020, we announced a delay until further notice to the activation of these for OPPS providers with multiple service locations. CMS policy or operation subject matter experts also reviewed/cleared this SE Article. This SE Article educates on national testing. Revisions to this SE Article include following content updates:
• Added information on how to handle certain off-campus provider-based departments excepted from Section 603 payment policy
The previous version of this SE Article is available to the public and currently posted on the CMS website at https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnmattersarticles/downloads/se19007.pdf
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 05, 2024
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.