More fun for all home health providers.
If some of your claims to CGS have returned to you unpaid, the reason may be the one CGS is currently trying to fix. See below for details.
Meanwhile, be well. And keep on swimming!
Beth
JURISDICTION 15 HOME HEALTH & HOSPICE
February 27, 2025
The Provider Contact Center (PCC) has reported a large number of calls regarding reason code 37257 for some HH providers. HH claims that contain Core Based Statistical Area Codes (CBSA) for urban that changed to rural are incorrectly returning to providers (RTP) with reason code 37257. The codes are correct according to the Home Health PPS Wage Index files but were changed/updated for CY 2025.
CMS has identified an issue in the pricer and is researching. A new pricer will be released to correct this issue. This item has been added to the Claim Payment Alerts webpage. Please visit this webpage for updates on this issue.