CAH Method II Overpayments Related to Annual Wellness Visit

In July 2013, Medicare Administrative Contractors (MACs) began to recover overpayments on Annual Wellness Visit (AWV) claims with dates of service on and after January 1, 2011 that were processed by Medicare on and after April 4, 2011 through March 31, 2013 (see MLN Matters® Article # 8153).

It was subsequently determined that both the professional and technical components of Method II critical access hospital (CAH) claims had been identified as overpayments and recouped in error. Method II CAHs are entitled to payment for the professional components of these claims. In September, a system update prevented the problem going forward. Another systems update is planned for February that will allow MACs to refund the professional components of these claims that were recouped in error. Method II CAHs should not resubmit claims unless directed to do so by their MAC. For more information, click here.