CMS Updates Guidance to MACs Regarding Claims Hold

On October 21, CMS instructed all MACs to lift the hold on claims with dates of service on and after October 1, 2025 for certain services impacted by select expired Medicare legislative provisions, including claims paid under the Medicare Physician Fee Schedule and telehealth claims that CMS can confirm are for behavioral and mental health services. CMS continues to direct MACs to temporarily hold claims for non-behavioral/mental health telehealth services and for acute Hospital Care at Home claims.