The Centers for Medicare & Medicaid Services will permanently reduce the Comprehensive Error Rate Testing (CERT) program sample size starting with reporting year (RY) 2025. The sample size for improper payment measurement review will decrease from 50,000 to 37,500 claims annually.
If the CERT Review Contractor completes the RY 2025 review but removes a claim from the sample, they will notify the provider or supplier in writing.
The Medicare Administrative Contractor will adjust the claim as required to reflect the correct codes and payment, and pay or collect as needed.