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July 23 2025 Clinic Overpayments on Excluded Codes
July 23, 2025: Attention Clinic Providers: MDHHS has identified claims in which the clinic excluded codes were incorrectly overpaid, when other insurance was reported. Claims impacted are those with dates of service ranging from 5/1/2024 to 3/31/2025 with an excluded code not included in the PPS/AIR reimbursement.
Providers will have until October 3, 2025, to adjust any impacted claims to allow them to properly adjudicate. The adjustment claim must include the claim note of “Lesser of Rebill”. MDHHS will begin voiding impacted claims as of October 3, 2025, and continue until complete.