Medicare recently notified MassHealth that it will be adjusting certain End Stage Renal Disease (ESRD) claims for members in Medicare’s ESRD Treatment Choice Model. The adjustments start on January 20, 2025. Renal Dialysis providers are reminded that Medicare claim adjustments do not automatically cross over to MassHealth. Providers should adjust the crossover claim previously paid by MassHealth and include the revised Medicare adjudication information on the claim.
If you have questions, please contact MassHealth at provider@masshealthquestions.com or (800) 841-2900.
End Stage Renal Disease and Medicare Claim Adjustments