Part B Medicare Claims Hold for Claims With Services Impacted by Lapsed Legislative Provisions

In anticipation of possible Congressional action, CMS has instructed all Medicare Administrative Contractors (MACs) to continue to hold claims with dates of service of October 1 and later for services impacted by the expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025.

The hold only refers to services affected by the expired Medicare legislative payment provisions. This does not apply to most services submitted by most podiatrists. For most podiatrists, that hold only involves telehealth services. The hold could also impact podiatrists if services were performed in an area where Medicare payments are less than the national average. The hold does not apply to any other services.

Providers may continue to submit these claims, but payment will not be released until the hold is lifted.

Members can view all government shutdown resources at https://www.apma.org/shutdown. Please contact the APMA Advocacy Department with any questions or concerns.