Agencies
Services
Provider Notice issued 04/17/2026
Update to Hospital Reimbursement Component Hold Edits
| To: |
Participating Hospitals: Chief Executive Officers; Chief Financial Officers; and Patient Accounts Managers |
| Date: | April 17, 2026 |
| Re: |
Update to Hospital Reimbursement Component Hold Edits |
This notice informs providers of updates to the 10/01/2025 and 01/01/2026 holds on the hospital reimbursement components in the 12/02/2025 provider notice.
Effective March 23, 2026, all inpatient and outpatient claims on hold from 10/01/2025 have been released. This applies to the H98 Hold Edit (on hold for Mapper). Also released are the I42 and I43 Hold Edit (applied to new rates beginning 01/01/2026).
Claims submitted within the timely filing limit but rejected for billing errors may be rebilled. Fee-For-Service (FFS) claims that are past the 180-day timely filing limit must be billed with an HFS 1624A UB-04 Override Request Form requesting the G55 override or by contacting a consultant Monday, Wednesday, and Friday 8:30a-2:30p at 877-782-5565 Options 1, 2, 4, 1 to request systematic override. The Department must receive the rebilled claim or a phone request within 180 days from the date of this notice. Please refer to the Timely Filing Override Submittal Instructions on the Hospital and Institutional Providers webpage for detailed instructions.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565, or the applicable MCO.
Laura Phelan, Administrator
Division of Medical Programs