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Medicare AdvantageAdministrativeMedium impact

New Third Party Liability (TPL) Code to Identify Participants in a Medicare Advantage Plan (MAP) Effective with Dates of Service Beginning October 1, 2016

Illinois Medicaid - HFS·IL · Geriatrics·Provider Notice
Effective date
Oct 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

A new Third Party Liability (TPL) Code 920 must be used to identify participants enrolled in Medicare Advantage Plans (MAP) for long-term care facilities. This code must be reported in specific claim segments along with MAP payment amounts when billing Medicaid as secondary payer.

Action Required

Action needed
For dates of service beginning October 1, 2016: Long-term care billing teams must use TPL Code 920 in Claim Loop 2330B/REF-Other Payer Secondary Identifier segment with 2U qualifier when billing for Medicare Advantage Plan participants. Report MAP payment amounts in Claim Loop 2320 AMT segment. Update billing software to handle 24-month timely filing limit for claims with this TPL code. Failure to include proper TPL information will result in claim rejection with error code L24.