Palmetto and CGS have posted that this issue is now resolved and NOA records are no longer being Returned to Provider (RTP) with Reason Code 31254 due to the MAC assigning an incorrect Julian date in the DCN. If an NOA was late due to this issue, enter the remarks required by your agency's MAC in the Remarks field of the final claim (ex. Issue with RC 31254). See the NOA Creation FAQ for instructions on submitting a Late NOA Exception Request.
RTP U5235
Some agencies have had NOAs RTP for Reason Code U5235 in error. CGS has posted that a system fix will be implemented at a future date. If an NOA was late due to this issue, enter the remarks required by your agency's MAC in the Remarks field of the final claim (ex. Issue with RC U5235). See the NOA Creation FAQ for instructions on submitting a Late NOA Exception Request.
If your agency has not already updated the sequestration rate change effective 4/1/2022, please do so now. As of December 2021, the 2% sequestration payment adjustment for all Medicare Fee-For-Service (FFS) claims has been suspended until 3/31/2022, at which point a 1% adjustment would be active through 6/30/2022. The full 2% amount would then be applied starting 7/1/2022. Refer to the Sequestration Rates FAQ for more information.
Refer to the PDGM Payment Not Matching FAQ for other areas to check when PDGM billed amounts do not match reimbursement.