US · guidance
CMS Pub. 100-06, ch. 3, § 170.1
Offset of Overpayments Against Other Benefits Due – FI
A. Benefits Payable Under Part B - FI
Where the FI determines that a Part A overpayment has been made to a provider on behalf of a
beneficiary, it shall ascertain whether the beneficiary is entitled to any Part B payment for the services
in question. (See Medicare Benefit Policy, Chapter 6.) If it appears that Part B benefits are payable, it
shall arrange for billings under Part B. It shall use any Part B benefit as an offset against the Part A
overpayment.
B. Use of Lifetime Reserve Days - FI
If a Part A overpayment for which a beneficiary is liable was caused by payment for services rendered
after exhaustion of benefit period days, the FI shall reduce the amount of the overpayment by the
application of the beneficiary’s lifetime reserve days, unless the individual elected not to use them. An
individual who has been overpaid for services rendered after exhaustion of benefits can elect not to use
reserve days only if the individual refunds the overpaid amount. (See Medicare Benefit Policy, Chapter
5.)
History
(Rev. 29, 01-02-04)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
454a588a7d9d2d7eada03f150a372121df253833f9fe0a4196fd7977875c8da4
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