Medicare Credit Balance Report (CMS-838)

The Medicare Credit Balance Report (CMS-838) is used to disclose Medicare credit balance amounts that providers owe to the Medicare program. Typically, an improper or excess payment for a claim appears as a “credit” in a provider’s accounting records (patient accounts receivable). Providers should only report credit balances if they have not already repaid the amount to Medicare through a voluntary refund, received a remittance advice indicating that the adjustment associated with the credit has been adjudicated, or received a demand letter for the credit balance amount.

Providers utilize the CMS-838 report to disclose and determine the number and amount of these Medicare credit balances for refunding the Medicare program. While an improper or excess payment is generally reflected as a “credit” in a provider’s accounting records, Medicare credit balances encompass all money due to the program, irrespective of its classification in a provider’s accounting records. For instance, if a provider maintains credit balance accounts for a set period, such as 90 days, and then transfers or writes them off to a holding account, this does not absolve the provider of their liability to the program. In such cases, the provider remains responsible for identifying and repaying all these monies to the Medicare program.

Please note that as of December 1, 2024, providers are no longer required to submit the Medicare Credit Balance Report (CMS-838) on a quarterly basis. However, self-identified overpayments still need to be reported, but a Credit Balance Report should only be used when these overpayments occur.