CMS Transmittal – Expanding CAH Edits

CMS is expanding the claim editing to meet the Social Security Act requirements for the attending, operating, or other physician or non-physician practitioner when a plan of treatment is needed and submitted from a CAH. The expansion will verify the attending, operating, or other physician or non-physician practitioner provider on a CAH claim is eligible and enrolled in Medicare by allowing FISS to match data on a provider billed claim to that of a national PECOS file. For more information, click here.