Requesting a comparative billing report -- Part A providers

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Home ► CBR ► Requesting a comparative billing report -- Part A providers

Last Modified: 9/23/2020 Location: FL, PR, USVI Business: Part A

Requesting a comparative billing report -- Part A providers

Comparative billing report (CBR) information is available to providers by request. The purpose of the CBR is to show comparative data Medicare considers when determining how a provider’s billing patterns contrast with other providers in the same specialty. A CBR may be a helpful tool for providers when conducting self-audits.

Comparative billing reports by type of bill

Medicare compares a Part A provider to its peers by type of bill using quantity billed per beneficiary per procedure code. This type of CBR contains billing information for a provider in intervals defined by the requester.

Since Medicare bases a CBR on dates of service and not processed dates, Medicare must allow two to three months to permit claims to be finalized before a report can be generated. For example, January data is not available until April or May.

How to request a comparative billing report

To request a CBR, providers must follow these steps:

• A provider must request a CBR on office or corporate letterhead and the provider/officer signature must be affixed. A request from a corporate entity must be submitted by a corporate officer, or in the case of a hospital, the hospital administrator. If the requesting provider wants the information sent to another party, it must be noted in the letter.

• The mailing address must be stated clearly and legibly in the letter, since these reports will only be sent via the U.S. mail, and not electronically.

• The CBR request must include the Medicare provider number, the dates of service preferred, and the applicable type of bill. Due to the volume of data, Medicare cannot generate a report for types of bill 11X or 12X.

• The request must be faxed to Statistical and Medical Data Analysis at 904-361-0543 or mailed to:

First Coast Service Options
Statistical and Medical Data Analysis
P.O. Box 3411
Mechanicsburg, PA 17055-1825

There is no fee for providing these reports.

Once Medicare receives a CBR request, the report and a CBR explanation document will be mailed to the requesting provider (or authorized party) within 10 business days.

Source: CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 11.1.6

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