MassHealth identified an issue that caused incorrect pricing on certain group practice Medicare crossover claims, leading to overpayments. This occurred when the rendering provider was a mid-level practitioner and the place of service was 02 or 10 (telehealth). The issue has been resolved, and all impacted Medicare crossover claims adjudicated on or after February 1, 2023, have been adjusted. These adjustments will appear on this and future remittance advices.
If you have questions regarding this message, please contact MassHealth at provider@masshealthquestions.com or (800) 841-2900.
Adjusting Certain Group Practice Medicare Crossover Claims