The Centers for Medicare & Medicaid Services (CMS) has announced a temporary pause on Medicare claims payments effective October 1, 2025, as a result of the ongoing federal government shutdown. This action is part of standard CMS contingency plans when congressional payment “extenders” lapse without renewal.
Understanding the Medicare Claims Payment Delay
CMS has instructed all Medicare Administrative Contractors (MACs) to hold Medicare claims for up to 10 business days. While providers can and should continue submitting claims, reimbursements will not be issued until the pause is lifted. This measure helps avoid reprocessing should Congress restore funding retroactively.
Why This Medicare Payment Pause Affects Your Practice
Although CMS cites the existing 14-day payment floor as a buffer, the delay may still affect provider cash flow—particularly for small practices and rural healthcare providers who depend heavily on timely Medicare reimbursements.
Actionable Steps for Healthcare Providers During the Shutdown
To reduce operational disruption and protect your revenue cycle, consider the following:
Submit Claims As Usual – Continue normal claims submission to prevent backlogs and ensure prompt payment once the hold ends.
Assess Financial Health – Review your cash flow reserves and prepare for potential short-term gaps, especially if your practice is Medicare-dependent.
Keep Teams Informed – Alert billing staff, finance teams, and practice leaders about the expected delay to align on timelines and expectations.
Stay Updated with CMS and MAC Communications – Regularly monitor official sources for updates. Key resources include:
Your regional MAC’s website (e.g., Noridian, NGS, Palmetto, etc.)
Revise Revenue Cycle Plans – Temporarily adjust accounts receivable forecasts and payment schedules. Consider:
Review budgets and adjust as necessary
Accelerating collections from other payers
Proactively communicating with vendors or creditors if needed
Prepare for Post-Shutdown Processing – Once the government reopens, be ready to:
Reconcile delayed payments
Review remittance advice for accuracy
Handle any necessary claim reprocessing
By staying proactive and informed, healthcare providers can better navigate this temporary Medicare payment interruption and maintain financial stability during the government shutdown.
