2020 IPPS hospital wage-index errors may have led to incorrect payments

Eighty-four hospitals may have received incorrect payments for discharges on or after October 1 due to errors in the hospital wage-index table published in the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) pricer, according to CMS. Transmittal 4477, issued December 13 and retroactively effective October 1, corrects the errors and instructs Medicare Administrative Contractors (MAC) to reprocess affected claims.

In all cases the correct wage index is lower than that originally published in the hospital wage-index table. A revised FY 2020 IPPS pricer will be released in January 2020. MACs are instructed to revise the data elements for effected hospitals to automatically generate the correct wage index. CMS will issue separate instructions addressing any incorrect payments due to the error that may already have been made, according to Transmittal 4477.

Affected hospitals should consider reviewing claims for services on or after October 1 to determine if they may have received incorrect payments. Stay alert for additional instructions from your MAC.