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News & Press: General

PalmettoGBA Payment Issue with CCM Code G0511

Monday, April 30, 2018   (0 Comments)
Posted by: William Feagin
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Please Make Note: Payment Issue with Chronic Care Management Code G0511


I spoke with my contact over at PalmettoGBA this morning.  The “issue log” is connected to Jurisdiction M for South Carolina.  So, in the next 45 days (taking into account the issue log date) they should have the issue resolved and will recycle all claims back to 01/01/2018. The reference number that is logged at PalmettoBGA for this issue is #4314336.

FROM the Issues Log:

Date Reported: 04/13/2018

Status: Opem

Provider type: FQHC/RHC

Description of Issue: It has been brought to the attention of CMS that the claims processing system is reading the incorrect rate for care management services.

Claim Coding Impact: G0511 and G0512

MAC Action Date: 04/13/2018 - CGS will update the codes and adjust affected claims from January 1, 2018 to present to correct the rate within approximately 60 business days.