CMS Announces Medicare Claims Hold Update
Published November 03, 2025
By AACOM Government Relations
Federal Policy
OME Advocate
- On Oct. 21, 2025, the Centers for Medicare & Medicaid Service (CMS) instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service of Oct. 1, 2025, and later for certain services impacted by select expired Medicare legislative payment provisions.
- The update includes claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims and Federally Qualified Health Center claims, as well as telehealth claims that CMS can confirm are definitively for behavioral and mental health services. As the shutdown continues, MACs have been directed to continue the temporary hold on claims for other telehealth services (i.e., those that CMS cannot confirm are definitively for behavioral and mental health services) and acute Hospital Care at Home claims.
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