Error Rate Testing
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Comprehensive Error Rate Testing (cert)
Archive - Opens in a new window Share Help Print Learn about your health care options Search CMS.gov Main Menu Medicare Medicaid/CHIP Medicare-Medicaid Coordination Private Insurance Innovation Center cms comprehensive error rate testing Regulations & Guidance Research, Statistics, Data & Systems Outreach & Education You are here: Home > Research, Statistics, Data and Systems > Medicare Fee-for-Service Compliance Programs > Comprehensive Error Rate Testing (CERT) > Comprehensive Error Rate Testing (CERT) Comprehensive Error Rate Testing (CERT) Background Information for Providers CERT Reports Additional Data Medicare FFS Jurisdiction Error test error rate in r Rate Contribution Data Comprehensive Error Rate Testing (CERT) The Centers for Medicare & Medicaid Services (CMS) calculates the Medicare Fee-for-Service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. Each year, CERT evaluates a statistically valid random sample of claims to determine if they were paid properly under Medicare coverage, coding, and billing rules. The fiscal year (FY) 2015 Medicare FFS program improper payment rate is 12.1 percent, representing $43.3 billion in improper payments, compared to the FY 2014 improper payment rate of 12.7 percent or $45.8 billion in improper payments (1). The table below outlines the improper payment rate and projected improper payment amount by claim type for FY 2015. The reporting period for this improper payment rate is July 1, 2013 -June 30, 2014. Service Type Improper Payment Rate Improper Payment Amount (2) Inpatient Hospitals 6.2% $7.0B Durable Medical Equipment 39.9% $3.2B Physician/Lab/Ambulance 12.7% $11.5B Non-Inpatient Hospital Facilities 14.7% $21.7B Overall 12.1% $43.3B All public reports produced by
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Archive - Opens in a new window Share Help Print Learn about your health care options Search CMS.gov Main Menu Medicare Medicaid/CHIP Medicare-Medicaid Coordination Private Insurance Innovation https://www.cms.gov/cert Center Regulations & Guidance Research, Statistics, Data & Systems Outreach & Education You are here: Home > Research, Statistics, Data and Systems > Medicare Fee-for-Service Compliance Programs > Comprehensive Error Rate Testing (CERT) > CERT Reports Comprehensive Error Rate Testing (CERT) Background Information for Providers CERT Reports Additional Data Medicare FFS Jurisdiction Error Rate https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/CERT/CERT-Reports.html Contribution Data CERT Reports Each November, the Department of Health and Human Services (HHS) publishes the improper payment rate in the Agency Financial Report at www.hhs.gov/afr. CMS later publishes more detailed improper payment rate information in the form of the annual Medicare Fee-for-Service (FFS) Improper Payments Report and Appendices. This list contains reports produced by the Comprehensive Error Rate Testing (CERT) program, including the annual Medicare FFS Improper Payments report. Loading Report Year Report Name Release Date 2006 Mid-Year Over-Utilized Codes List 05/18/2006 2004 Medicare Fee-for-Service Fiscal Year 2004 Improper Payments Short Report 12/13/2004 2003 Medicare Fee-for-Service Fiscal Year 2003 Improper Payments Short Report 11/15/2003 2004 Medicare Fee-for-Service Fiscal Year 2004 Improper Payments Report 12/17/2004 2003 Medicare Fee-for-Service Fiscal Year 2003 Improper Payments Report 11/15/2003 2006 Medicare Fee-for-Service 2006 Mid-Year Improper Payments Short Report 05/18/2006 2007 Medicare Fee-for-Service 2007 Mid-Year Improper Payments Report 05/15/2007 2006 Medicare Fee-for-Service 2006 Improper Payments Report 11/15/2006 2012 Medicare Fee-for-Service 2012 Improper Payments Report 2013-09-09 2012 Appendic
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