CMS implemented an enhancement to the Electronic Remittance Advice (ERA) on July 6, 2026, that helps providers identify the source of affiliate withholds. When an affiliate withhold occurs, the ERA detailed summary page now includes the Provider Transaction Access Number (PTAN) associated with the debt being satisfied through the withhold. This enhancement applies to both claim-related and cost report-related affiliate withholds.

Previously, providers often contacted the Provider Contact Center to determine which affiliated provider's debt resulted in the withholding. With the ERA enhancement, this information is available directly within the remittance data, allowing providers to identify the affected PTAN and determine the appropriate follow-up action.

Understanding Provider Level Balance (PLB) Codes E3 and OB Affiliate Withholds

E3 - Claim Affiliate Withhold

• Used when funds are withheld to satisfy a debt associated with a specific beneficiary account belonging to an affiliated provider.
• Generally, claim-related and tied to beneficiary-level accounts receivable.
• ERA detailed summary page includes the PTAN associated with the debt and amount withheld.

OB - Cost Report Affiliate Withhold

• Used when funds are withheld to recover a cost report-related debt owed by an affiliated provider.
• Typically associated with facility-level financial adjustments resulting from cost report settlements, estimated reimbursement rates, pass-through payments, or Periodic Interim Payments (PIP) payments.
• These adjustments are not linked to a specific beneficiary. They apply to the provider organization's overall financial reconciliation.

What Providers Should Do

When an affiliate withhold appears on your ERA, review the detailed summary page before contacting the Provider Contact Center. The PTAN included on the detail page identifies the provider whose debt was satisfied through the withholding and may answer questions without additional outreach. If your clearinghouse does not provide the ERA detailed summary page, contact the clearinghouse and request that the complete ERA detailed summary be included, as it is transmitted as part of the ERA data from CMS.