License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. BY CLICKING BELOW ON THE BUTTON LABELED "I ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT.

IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "I DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN.

IF YOU ARE ACTING ON BEHALF OF AN ORGANIZATION, YOU REPRESENT THAT YOU ARE AUTHORIZED TO ACT ON BEHALF OF SUCH ORGANIZATION AND THAT YOUR ACCEPTANCE OF THE TERMS OF THIS AGREEMENT CREATES A LEGALLY ENFORCEABLE OBLIGATION OF THE ORGANIZATION. AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING.

Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association website.
Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Please click here to see all U.S. Government Rights Provisions.
ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT-4 is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. No fee schedules, basic unit, relative values or related listings are included in CDT-4. The ADA does not directly or indirectly practice medicine or dispense dental services. The sole responsibility for the software, including any CDT-4 and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third-party beneficiary to this Agreement.
CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. If the foregoing terms and conditions are acceptable to you, please indicate your agreement by clicking below on the button labeled "I ACCEPT". If you do not agree to the terms and conditions, you may not access or use the software. Instead, you must click below on the button labeled "I DO NOT ACCEPT" and exit from this computer screen.

Overpayment Recovery

If you receive overpayment, you are obligated to refund the money to Medicare. Click below to learn more.

What Is an Overpayment?

Overpayments are Medicare payments to a supplier in excess of amounts due and payable under the statute and regulations. Once a determination of an overpayment has been made, the amount is considered a debt owed by the debtor to the United States Government. CGS must attempt recovery of the overpayment in accordance with the Centers for Medicare & Medicaid Services (CMS) regulations.

CMS requires CGS to request refunds on non-MSP overpayments of $25 or more. If a supplier owes several small overpayments, each of which is less than $25, the total of the overpayments will be added together, and a demand letter will be issued. The $25 tolerance does not apply to MSP overpayments.

There are two types of voluntary refunds:

Non-MSP – where Medicare fee-for-service is primary, and
MSP – where Medicare fee-for-service is secondary
If you need help deciding if Medicare should have paid as primary or secondary, see our MSP section.

The purpose of Overpayment Recovery is to recover money overpaid in error to a Medicare beneficiary or supplier. The funds can be recovered voluntarily from the beneficiary or supplier through a voluntary payment or through a demand letter.

Overpayment Refund Requests & Timelines

CGS can initiate an overpayment refund request (demand) or the supplier can voluntarily issue a refund (voluntary refund).
When CGS determines that a supplier has been overpaid, we'll send a refund request through an overpayment demand letter. This letter includes a document control number (DCN) which must be included in all communication with us to ensure accurate tracking and application of the refund.

Refund Timelines

You have 30 days from the date of the demand letter to refund CGS. If we don't receive your payment within 30 days, interest begins to accrue on the refund amount. If we still haven't received full payment by the 40th day, the recoupment process will begin in the form of an offset. Current and future payments will be offset until the overpayment is completely recouped.

Debt Collections

If CGS has not received requested payments by 120 days after the initial demand letter the debt will then be referred to the Department of Treasury.

How Do I Refund an Overpayment?

You can return Medicare overpayments in the following ways:

Immediate Offset

If you receive a demand letter and want CGS to take the overpayment out of your future Medicare payments, submit the Offset Request Form. CGS will then reduce your next payments until the overpayment is repaid.

Overpayment Recovery Request

If you identify an overpayment, you can start the recovery process by submitting the Overpayment Recovery Request Form. After CGS processes the form, CGS will issue a demand letter.

Examples when to use this form:

Items are returned
Billing mistake happened
Medicare Secondary Payer (MSP) situations caused an overpayment

Voluntary Overpayment Refund Request (with check)

You may also repay the overpayment voluntarily by sending CGS a check along with the Voluntary Overpayment Refund Form

If you receive a demand letter, include a copy of it with your check so that we apply the refund correctly.
For Medicare Secondary Payer (MSP) related overpayments, include a copy of primary insurance's explanation of benefits (EOB).

If your check doesn't fully satisfy the overpayment, the same rules will apply regarding the overpayment demand letters. In addition, the same interest and offset rules will apply if the overpayment is not satisfied in a timely manner.

Please allow CGS up to 60 days from the date of receipt to process voluntary refunds and up to 20 days to process demand-related refunds.

Form

Submission Options

Offset Request Form (offset)

Overpayment Recovery Request Form (initiate the overpayment process)

Online: myCGS DME® Web Portal
Fax: 615.782.4508
Standard Mail:
CGS Administrators, LLC – DME JB
PO Box 953479
St. Louis, MO 63195-3479
Overnight Delivery:

CGS Administrators, LLC – DME JB
Lockbox 953479
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045

Voluntary Overpayment Refund Form (return overpayment by check)

Standard Mail:
CGS Administrators, LLC – DME JB
PO Box 953479
St. Louis, MO 63195-3479
Overnight Delivery:

CGS Administrators, LLC – DME JB
Lockbox 953479
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045

How Do I Appeal an Overpayment?

DO NOT request a redetermination until you receive your Overpayment Demand Letter.

When you receive a demand letter to refund an overpayment, it is in your best interest to immediately refund the requested amount. This will help you avoid an offset and accruing interest.

Complete the Redetermination Request Form. When completing the form, follow these tips:
- Select Yes in the Overpayment Appeal section of the form
- Indicate who requested the overpayment (Medical Review, UPIC, CERT, SMRC, or Recovery Auditor)
- List the claim control number (CCN) of the adjusted claim that reflects the overpayment
- Submit one request per demand letter
- Specify in your request if you wish to appeal the entire amount of the overpayment demand letter or only certain claims. For cases involving multiple beneficiaries, it may be helpful to include a spreadsheet or list containing all of the items identified on the Redetermination Request Form.
When you submit the form, include the following items if they apply:
- Copy of the audit results letter
- Copy of the overpayment demand letter
- Documentation needed to support the appeal

Redetermination Submission Methods

Contact Information/Instructions

myCGS® DME Web Portal

*The fastest and easiest way to submit redetermination requests

For existing users, see the myCGS User Manual, Chapter 6 – Reprocessing
To register for the myCGS portal, see the Registration Guide

Overpayment Appeals Fax

615.660.5976

Mail

CGS – Jurisdiction B Redeterminations
PO Box 20007
Nashville, TN 37202

Financial Hardship Options

Accelerated & Advance Payments

When suppliers have financial difficulty due to delayed Medicare payment for services provided, they may qualify for accelerated or advance payments.

Make sure you meet all requirements outlined in the accelerated or advance payments article.
Complete the Accelerated or Advance Payment Request Form, which must be certified by the supplier's CEO or CFO.

Bankruptcy

Filed bankruptcy and need to notify CGS? Send a copy of the bankruptcy notification given by the courts to the address below:
CGS
PO Box 20007
Nashville, TN 37202-0010

Extended Repayment Schedule

If a lump sum refund would cause severe financial hardship, you can request Extended Repayment Schedule (ERS).

Make sure you follow the steps outlined in the Extended Repayment Schedule (ERS) article.
Complete the Request for an Extended Repayment Schedule Form.

Overpayment Resources

Online Education Courses

Tools

Overpayment Interest Calculator

Updated: 08.20.2026
Reviewed: 08.20.2026