Agencies are still struggling to keep up with their patients’ Medicare enrollment status, according to the latest top claims error data from CGS.
 
The Medicare Administrative Contractor released its updated top 10 list for claim submission errors Sept. 17, 2025.
 
At No. 2: Dates of service billed are within a beneficiary's Medicare Advantage (MA) plan enrollment period; therefore, no Medicare payment can be made.
 
Here’s the full top 10:
 
1. A Home Health (HH) Notice of Admission (NOA) overlaps an existing HH admission.
2. Dates of service billed are within a beneficiary's Medicare Advantage (MA) plan enrollment period; therefore, no Medicare payment can be made.
3. Statement "From" Date is on or after 01/01/2022 and less than 24 months from claim "Admit" Date and a matching Home Health Notice of Admission (NOA) cannot be found.
4. This reason code is assigned when there is no corresponding OASIS assessment found in Medicare's systems related to the claim.
5. Episode "To" date not 30 days greater than "From" date
6. The dates of service fall within the span of days between the NOA receipt date and the claim From date on TOB 32X with Statement From Date on or after 01/01/2022, the NOA receipt date is 30 or more days from the claim From date, the payment amount returned from HH Pricer is equal to zero and the PROVIDER REIM field on MAP103A is blank.
7. This home health claim was submitted as a Medicare primary claim and contains exact service dates corresponding to a previously submitted claim for the same provider with at least one matching revenue code.
8. The From and Through dates on HH claim are outside the HH Admission period.
9. The Fiscal Intermediary Standard System (FISS) has found a previously submitted billing transaction for the same beneficiary and dates of service with the same provider number; therefore, the second billing transaction submitted by the provider is a duplicate.
10. The HCPCS G-code submitted is not reported with the correct corresponding revenue code.