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Last Modified: 4/8/2021 Location: FL, PR, USVI Business: Part A, Part B

Learn about CMS' amended repayment process for accelerated and advance repayments

Under the expanded Accelerated and Advance Payments (AAP) Program, CMS issued payments to providers and suppliers to help ease financial strain due to a disruption in claims submission and/or claims processing related to the COVID-19 public health emergency.
Recently, Congress enacted amended repayment terms for the accelerated and advance payments through the Continuing Appropriations Act, 2021 and Other Extensions Act:
Repayment will now begin one year after the date of the issuance of the payment.
During the first 11 months after repayment begins, repayment will occur through an automatic recoupment of 25% of Medicare payments otherwise owed to you.
During the succeeding six months, repayment will occur through an automatic recoupment of 50% of Medicare payments otherwise owed to you.
If you are unable to repay the total amount of the accelerated or advance payment through recoupment within 29 months, you will receive a demand letter requiring repayment of any outstanding balance, subject to an interest rate of 4%.
No action is necessary from you. The repayment process will begin automatically.

Example of AAP repayment terms

The following example helps illustrate the amended repayment terms for a provider that was issued an AAP on April 1, 2020:
We highly recommend that providers/suppliers create a way, during the 29-month recoupment period, to track the claims submitted, Medicare reimbursement received, and Medicare reimbursements recouped. This will help you reconcile the payments recouped towards your AAP receivable in your system as they are a part of the payback process.
How will I recognize the AAP offset on my remittance advice?
The AAP offsets will be assigned a specific accounts receivable number that starts with 'CVD' and will show as a withholding on your remittance advice. Keep in mind other offsets can occur on the same remittance advice that are claim related, so we encourage you to have a tracking mechanism for the AAP as well as your patient specific accounts.
Will the recoupment be identified on a per beneficiary claim line?
No. There will be no specific beneficiary claim line to refer to. The offset amount is taken from the total of the remittance payment.
How will the AAP recoupment impact my patient accounts?
Because the AAP was given as emergency funds, it will not impact the way a claim processes. The recoupments are not linked to patient accounts. We will recoup the amount from the finalized provider payment (after any other deductions are met for other withholdings). This total amount is to repay the monies advanced last year that now need to be applied by the recoupments. You will need to determine the best way for your organization to balance the previous AAP amount with each recoupment.
Can the AAP offset apply to affiliate provider accounts if we share the same Tax Identification Number (TIN)?
Yes, if a single TIN includes multiple PTANs for periodic interim payment (PIP) and non-PIP providers, the recoupment percentage will be offset at the TIN level. The offset will not exceed the maximum recoupment rate of 25% or 50%.
Can I request an exception or extension on the repayment terms for my AAP?
We recognize that the COVID-19 public health emergency continues to present challenges for Medicare providers and suppliers. Recall that the normal Medicare requirement is to recoup a debt a 100%; however, CMS understood this challenge and developed a flexible payment arrangement at 25% for the first 11 months and 50% for another six months with zero interest to ease providers’ burden during the PHE. We are unable to offer any modifications or exceptions to these repayment terms.
Can I submit a voluntary refund instead of waiting for the amended repayment process to begin?
Yes. Providers and suppliers that received an AAP payment can return the money via a check if the amount does not exceed $70M. You can use the return of monies voluntary refund form pdf file with a comment in the "Other" box stating it is for the AAP.
Can providers still submit a request for an AAP payment?
Effective October 8, 2020, MACs are no longer accepting payment request forms from providers. Applications received on or after this date shall be declined.
Will interest accrue on my account?
If all monies have not been paid at the end of the total 29-month timeframe a demand letter will be issued with a total amount of monies still owed. Interest will accrue at this time at 4%.
Have additional questions?
If you have any additional questions regarding the AAP repayment process, please contact our hotline at 1-855-247-8428. Our hours of operation are 8:30 a.m.–4 p.m. ET M-F.
Review CMS resources:
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.