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Editing for Duplicate Processing for Practitioner Professional Services and Critical Access Hospital (CAH) Professional Services

The purpose of this Change Request (CR) is to prevent duplicate billing of professional claims from CAHs and professional physicians that were identified in Office of Inspector General (OIG) Report: Duplicate Medicare Professional Fee Billing by Both the Critical

Download the Guidance Document

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

Issue Date: January 10, 2025

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.