CMS Pub. 100-06, ch. 6, § 260.1

The A/B MAC (B) reports on Page 12 of the CMS-1565 data on the claims on which it paid

interest because it paid the claims after the required payment date per §9311 of the Omnibus

Reconciliation Act of 1986 (OBRA 1986). It bases data shown on reliable counts of all claims

processing activity, not on estimates. It reports data on initial claims only. It includes in the report

all claims requiring interest payments in the month. It reports claims in the month the date of

payment falls. (For a discussion of interest payments refer to the Medicare Claims Processing

Manual, Publication 100-04, chapter 1, sections 80.2.2 and 80.2.2.1).

The A/B MAC (B) completes the report for each column as follows:

Column 1. Total - Data for all claims (real and replicate) for which interest payments were

made during the month.

Column 2. Assigned Physician - Data for the assigned claims included in column 1 which

involved services billed by physicians. Physicians are identified by specialty

codes 01-14, 16-30, 33-41, 44, 46, 48, 66, 70, 72, 76-79, 81-86, 90-94, 98, 99, C0,

C3, C5, C6, C7, C8, C9, D3, D4, D7, D8, E1, E2, E3, E4, E5, E6, E7, E9, F1, F2,

F3, F4, F5, F6.

Column 3. Assigned DME - Data for the assigned claims included in column 1 that involved

services billed by DME suppliers.

Column 4. Assigned Lab - Data for the assigned claims included in column 1 that involved

services billed by an independent laboratory. Independent laboratories are

identified by specialty code 69.

Column 5. Assigned Ambulance - Data for the assigned claims included in column 1 that

involved services billed by ambulance service suppliers. Ambulance service

suppliers are identified by specialty code 59.

Column 6. Assigned Other - Data for the assigned non-physician claims included in column 1

but not represented in columns 3, 4, or 5.

Column 7. Unassigned - Data for the unassigned claims included in column 1.

Column 8. Participating Physician - Data for claims involving services rendered by physicians

enrolled in the Medicare Physician/Supplier Participation Program.

On line 1, the A/B MAC (B) shows the number of claims on which it paid interest in the reporting

month. It reports on line 2 the number of claims included in line 1 for which it made payment 1

day after the required payment date (e.g., the required payment date is 17 days after receipt for

participating physician claims received in FY 1992.) (See §9311 of OBRA 1986.) Data for lines

3-10 are similar to those for line 2.

The A/B MAC (B) calculates the number of days late by subtracting the Julian date of the required

payment date from the Julian date of payment.

On line 11, it shows the amount paid in interest for claims reported in line 1. On lines 12-20, it

shows the amount paid in interest for claims reported in lines 2-10, respectively. It shows dollar

amounts on lines 11-20 to the nearest penny, and includes the decimal point.