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Medicare AdvantageAdministrativeMedium impact

Reporting Sequestration for Medicare Part C Plans

Missouri Medicaid (MO HealthNet)·MO·Provider Notice
Effective date
Apr 1, 2013
We identified it
Jun 20, 2026
Days to comply

Summary

Providers must properly report Medicare sequestration reductions when billing Medicare Part C crossover claims by entering the appropriate CARC codes (223 or 253) for each paid line and calculating the 2% reduction amount for each line detail.

Action Required

Action needed
Immediately: Billing team must update crossover claim procedures for Medicare Part C plans to enter CARC 223 (for dates of service 4/1/2013-1/5/2014) or CARC 253 (for dates of service 1/6/2014 and after) on each paid line detail, calculate the 2% sequestration reduction for each line, and ensure CO-253 amounts equal the total reduction amount when billing electronically on emomed.