Claims for RHC and FQHC visits at Skilled Nursing Facilities (SNFs) inappropriately rejected with Common Working File (CWF) edit C7252

CMS has found that claims for RHC and FQHC visits at Skilled Nursing Facilities (SNFs) are being inappropriately rejected with Common Working File (CWF) edit C7252. As a result, a CWF fix is set to be implemented on October 6, 2025.

Upon the successful implementation of the CWF fix, MACs shall mass adjust any claims for RHCs and FQHCs visits at a SNF that meet the following criteria:

  • TOB: 71X OR 77x
  • Reason Code: C7252
  • Status location: RB9997 or PB9997 (with C7252 on the line)
  • Date of service: on or after 07/1/2025
  • Receipt date: on or after 08/01/2025

MACs shall complete mass adjustments by November 15.

Last Updated Oct 08 , 2025