Credit Balance Reports - JE Part A
Credit Balance Reports
CMS requires a Credit Balance Report (CMS-838) be submitted within 30 days after the end of each quarter for all providers participating in the Medicare program.
A credit balance exists when a facility receives an overpayment for a Medicare service, for example:
- A facility is paid twice for the same service either by Medicare or by Medicare and another insurer
- A facility is paid for services planned but not performed or for non-covered services
- A facility is overpaid because of errors made in calculating beneficiary deductible and/or coinsurance amounts
- A facility bills and is paid for outpatient services included in a beneficiary's inpatient claim
Submit Credit Balance Reports via Credit Balance 838 Forms fax number by the due dates below.
Credit Balance Due Dates
General Instructions for Completing CMS-838
- CMS 838 Form and Instructions - Credit Balance Report complete instructions, Certification Page, and Details Page are available on CMS website
- Noridian 838 Form in Excel Format - Facilities may recreate CMS 838 in a spreadsheet program so they can enter credit balance data electronically; for your convenience, Noridian has created a version of CMS 838 in Excel that providers may download. If using Noridian Excel format to submit CMS 838 spreadsheet electronically, mail spreadsheet on a disk along with printed, signed certification page to Noridian
- Certification Page Tutorial - Certification Page is required by each provider on a quarterly basis and accompanies Credit Balance Report. Facilities without any credit balances during a quarter need to submit only signed certification page for that quarter. An officer (the Chief Financial Officer or Chief Executive Officer) or Administrator of facility must sign and date certification page. Noridian has prepared a tutorial that offers hover-and-view instructions to assist providers in understanding required elements of each section of Certification page
- Detail Page Tutorial - A separate Detail Page must be completed for Part A and B of A. On detail page, providers must enter information about each credit balance on a claim-by-claim basis
Provider-based Home Health Agencies must submit their CMS 838 to their Regional Home Health Medicare contractor.