Comprehensive Error Rate Testing Program: Reduced Sample Size Starting RY 2025

CMS will permanently reduce the Comprehensive Error Rate Testing (CERT) program sample size starting with reporting year (RY) 2025. The sample size for improper payment measurement review will decrease from 50,000 to 37,500 claims annually.

If the CERT Review Contractor (RC) completes the RY 2025 review but removes your claim from the sample, they’ll send you a letter. The removal is only applicable to the specific claim identified; that claim is no longer included in the improper payment measurement review. If you have not submitted documentation, you do not need to submit documentation to the CERT RC. If you have already submitted medical documentation, we appreciate the prompt response. You can monitor your CID on CERT's C3HUB using the claim search feature.

Palmetto GBA will adjust the claim if required to reflect the correct codes and payment, and pay or collect if needed.