Credit Balance Reporting (CMS-838)
The quarterly Credit Balance Reports (CMS-838) are due within 30 days of the end of each calendar quarter. The credit balance report is used to disclose Medicare credit balance amounts due from the provider to Medicare as of the last day of each quarter. Generally, when a provider receives an improper or excess payment for a claim, it is reflected in their accounting records (patient accounts receivable) as a "credit." Credit balances should only be reported at the end of the quarter if the provider has not repaid the amount to Medicare through a voluntary refund, has not received a remittance advice indicating that the adjustment associated with the credit has been adjudicated, or has not received a demand letter for the credit balance amount.
The CMS guidelines governing these processes can be found on the CMS website under Publication 100-06 – Medicare Financial Management Manual, Chapter 12 (PDF, 201 KB).
Palmetto GBA is committed to helping providers understand the credit balance process. For more information and the options available to you, please select the link below for additional information regarding the credit balance process.
| Topic | Brief Description |
|---|---|
| Submitting the Credit Balance (838) Report and Due Dates | A complete and acceptable Medicare Credit Balance Report (CMS-838) is due within 30 calendar days from the end of each calendar quarter. |
| Use Palmetto GBA's eServices to Submit Your Quarterly Credit Balance Report | Are you still using paper to submit your quarterly credit balance report via fax or email? Take advantage of the benefits of submitting your report electronically. |
| Credit Balance Report Related Adjustments or Cancelations | Helpful tips for submitting claim adjustments or cancelations associated with the credit balance report. |
| Common Rejection Reasons and Helpful Hints | Complete and accurate credit balance reports are required. If a credit balance report is rejected, a complete and accurate report will need to be resubmitted. |
| Corrections and Requests after Submitting the Credit Balance Report | After submission of an acceptable credit balance report, providers may determine that a correction needs to be made to information provided on the detail page submitted with the credit balance report, may determine that funds collected on a credit balance should be refunded, or want to provide additional information to correct claim history after a credit balance demand letter has been issued. |
| Credit Balance Webcast | For more information on the credit balance process, please see our Credit Balance webcast. |
| Credit Balance Report Module | This interactive module provides assistance with completing the Medicare Credit Balance Report (CMS-838). |