POS 10 Pricing at Facility Rate - Resolved 04/12/24

Provider/Supplier Type(s) Impacted: Telehealth

Reason Codes: Not applicable.

Claim Coding Impact: Not applicable.

Description of Issue: Noridian is aware Place of Service (POS) 10 telehealth claims are pricing at the facility rate regardless of the provider specialty.

Noridian Action Required: Noridian will provide more information as it is available.

Provider/Supplier Action Required: No action required at this time.

Proposed Resolution/Solution: CMS is aware MACs are receiving inquiries regarding how the system is pricing telehealth claims. CMS is looking into the matter, no ETA for the answer has been provided. Noridian will provide more information as it is available.

02/13/24 - CMS is looking into the matter, no ETA for the answer has been provided. Noridian will provide more information as it is available.

02/28/24 - The system logic was updated on 02/27/24 to reflect a non-facility payment rate for claims received with POS 10. Noridian will initiate adjustments of claims with dates of service 01/01/24 through 2/26/24.

03/20/24 - An additional update to the system logic was required and completed on 03/11/24. Noridian started initiating adjustments of claims with dates of service 01/01/24 through 03/10/24 on 03/15/24. Another update will be provided once all adjustments are initiated.

04/12/24 - Noridian initiated adjustments on or before 04/10/24.

Date Reported: 01/29/24

Date Resolved: 04/12/24

Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )