CEPP

CEPP (Comprehensive Error Rate Testing Program) is a program implemented by the Centers for Medicare and Medicaid Services (CMS) to identify and prevent improper payments in the Medicare fee-for-service (FFS) program. The program uses a two-pronged approach to identify errors: a random sample of claims is reviewed for compliance with Medicare coverage, coding, and billing rules; and specific areas of concern are targeted for focused reviews.

Overview

The Comprehensive Error Rate Testing Program (CEPP) is a key component of CMS's efforts to reduce and prevent improper payments, protect the Medicare Trust Fund, and ensure that the Medicare program is paying correctly for services provided to beneficiaries. The program is designed to identify errors in the Medicare FFS program and to provide data to CMS and its contractors to help them improve the accuracy of Medicare payments.

Methodology

CEPP uses a two-pronged approach to identify errors. First, a random sample of claims is reviewed for compliance with Medicare coverage, coding, and billing rules. This random sample is designed to provide a statistically valid error rate that can be projected to the entire Medicare FFS program.

Second, CEPP targets specific areas of concern for focused reviews. These areas are identified through data analysis, input from CMS and its contractors, and other sources. The focused reviews are designed to identify and address systemic issues that are causing improper payments.

Results

The results of the CEPP reviews are used to identify and address systemic issues that are causing improper payments. The data from the reviews is used to develop corrective action plans, provide education and training to providers, and inform policy decisions.

See also

• Medicare
• Centers for Medicare and Medicaid Services
• Medicare Trust Fund

References

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