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Multi Carrier System (MCS) Modifications to Liability Assignment Regarding Therapy Cap Claim Denials

This CR changes the payment liability assigned to MCS edits enforcing the therapy caps for professional claims from PR (patient responsibility) to CO (contractual obligation).

Download the Guidance Document

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

Issue Date: August 15, 2003

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.