US · guidance
CMS Pub. 100-08, ch. 11, § 11.1.6
Reporting MR Savings in CROWD
Contractors shall report in CROWD only those actual savings that are generated from
MR claims review.
Include as MR savings the following:
• Actual savings that result from all coverage and coding reviews done for MR
purposes. Include all benefit category, statutory exclusion and, reasonable and necessary
reviews done for MR purposes.
Contractors shall not include as MR savings:
• Avoided costs (e.g. a reduction in the number of claims submitted, compared to
historical patterns, attributed to a new or revised LCD) shall not be considered "savings."
• Savings that result from coverage or coding reviews performed at the request of
the fraud unit.
• Savings that result from any review other than coverage or coding.
History
(Rev. 89, Issued: 11-26-04, Effective: 12-27-04, Implementation: 12-27-04)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
3336eebbae00f6c58b835a95b05e56d3f81df209ae6798d7c0ba273d298504fc
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