US · guidance
CMS Pub. 100-06, ch. 3, § 200.4.4
Recoupment Timeframes and Reconsideration Notices after
Decision
(Rev. 12261; Issued:09-22-23, Effective: 12-11-23; Implementation:12-11-23)
A. When does Recoupment Begin or Resume after the Reconsideration?
Timeframe Medicare Contractor Provider
Day 30 (following
reconsideration
decision)
Resume or begin
recoupment without
regard to the ALJ appeal
request 30 calendar days
from the Fully
Unfavorable
Reconsideration
Decision, and from the
revised demand letter for
Partially Favorable
decisions.
Must either pay
Overpayment in full or
submit request for an
Extended Repayment
Schedule (ERS) to avoid
recoupment.
Day 60 (following
reconsideration
decision)
Recoupment continues
until the debt is fully
collected. This is also
the timeframe to send the
Intent to Refer letter
(ITR) or refer to
Treasury when the ITR
was previously sent.
Provider can request an
ERS prior to the referral to
Treasury. Provider can
also appeal to the ALJ.
1. Contractors shall use the Exhibit 4: Reconsideration Revised Overpayment
Demand Letter specified in Chapter 3, Section 200.4.5 or use your discretion to modify
the language, accordingly, to reflect the outcome of the adjustments to the overpayment.
• This letter states that the providers, physicians, and other suppliers have been afforded
the opportunity for rebuttal in accordance with requirements of CFR 42 §405.373(2)
through §405.375.
History
(Rev. 12261; Issued:09-22-23, Effective: 12-11-23; Implementation:12-11-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5bcec04893370f8cbfb6e509b647a0f7ad2792a00cd9dfc1b6db15001bea33ed
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