OIG Epidural Steroid Injections Payment Audit

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) audit report recommends that Medicare Administrative Contractors (MACs) be directed to recover over $3.6 million that it considers inappropriate payments for epidural steroid injections. According to the OIG, these improper payments occurred because the Centers for Medicare & Medicaid Services' (CMS) oversight was not adequate to prevent payments for sessions exceeding coverage limits for 6- and 12-month periods.

MACs will be reaching out to physicians to request that they identify, report, and return any overpayments in accordance with the 60-day rule.

SIS will continue to monitor this issue and keep you apprised as information is released.

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