Industry Bulletins | December 2, 2020
CMS Announces Medicare Fee-For-Service Improper Payment Rate Down Nearly Four Percentage Points From 2016 To 2020
The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare fee-for-service (FFS) improper payment rate dropped from 10% in 2016 to 6.3% in 2020. The estimated annual amount of improper payments declined by $15 billion, from about $40 billion in fiscal year (FY) 2016 to about $25 billion in FY 2020.
CMS estimates the Medicare FFS program improper payment rate through the Comprehensive Error Rate Testing (CERT) program. Each year, the CERT program reviews a statistically valid stratified random sample of Medicare FFS claims to determine if they were paid properly under Medicare coverage, coding . . .