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US · guidance

CMS Pub. 100-04, ch. 1, § 130.4.1

Guidelines for Submitting Adjustment Requests

activein force · 2026-08-25 – presentas-observed

SNF-562, SNF-562.A

When an initial bill for outpatient services or inpatient Part B services has been submitted

and the provider or the FI discovers an error, the provider submits an adjustment request

to the FI. The FI submits the adjustment to CMS if there is a change in:

• The Part B cash deductible of more than $1;

• Covered charges of more than $1 on bills for surgery or other outpatient procedures;

• The servicing provider;

• The Part B blood deductible;

• The coinsurance amount greater than $1.99; or

• Procedure codes.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
e98701a53b6b465f22c82375392422fe2af04aa330e8e0f3655459a0963d5f25
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