On May 1, CMS acknowledged that previous upgrades to its contractors’ systems did not include the provisions necessary to process Medicare claims filed by ambulatory surgery centers for the professional services of physicians and non-physician practitioners. CMS has directed its contractors to modify their systems to accept and process these reassignment claims properly by October 1, 2009.
Practitioners may reassign their professional fees to an ASC (or other organization) by filing Form 855R with the Medicare Part B contractor. Such reassignments are permitted by Medicare policy, for example, if the practitioner is employed by or under contract with the ASC to provide patient care. Contractors have been directed by CMS to accept and process valid reassigned claims for dates of service on or after January 1, 2008, if the claim is brought to the contractor’s attention and has not already been paid to the ASC or the practitioner. In other words, contractors do not have an affirmative obligation to search for claims that were previously filed by ASCs and inappropriately rejected.