Skip to Main Content

Print | Bookmark | | Font Size: + |

May 16, 2022

Reminders About Sequestration

On December 10, 2021, the Protecting Medicare and American Farmers from Sequester Cuts Act was passed and impacts payment for all Medicare Fee-for-Service (FFS) claims:

  • No payment adjustment through March 31, 2022
  • 1% payment adjustment April 1 – June 30, 2022
  • 2% payment adjustment beginning July 1, 2022

The 1% payment reduction (sequestration) will be:

  • Applied to all Medicare FFS claims with a date of service /"through" date of service on or after April 1, 2022
  • Calculated after the approved amount is determined and the deductible and coinsurance are applied
    • Note: For claims with DOS that span April 1, 2022 (e.g., 031522 – 041522), the approved amount is determined based on the entire claim (not DOS on or after April 1 only).
  • Reported with claim adjustment reason code (CARC) 253 (Sequestration – reduction in federal payment) on the remittance advice

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved