Credit Balance Reporting

Quarterly Credit Balance Reports No Longer Required 
Starting December 1, 2024, providers aren’t required to submit Credit Balance Reports (CMS-838) (PDF) on a quarterly basis. You’re still required to report self-identified overpayments, but you should only use a Credit Balance Report when they occur.

The Credit Balance Report (CMS-838) is used to disclose Medicare credit balance amounts due from the provider to Medicare. 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 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).

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.