Medicare Compliance & Reimbursement

If inflation has hit your practice hard, we’ve got some good news for you on Medicare appeals fees.

Update: Amount in controversy (AIC) rates are updated annually and often increase based on inflation. For a second year in a row, the Centers for Medicare & Medicaid Services (CMS) has opted to keep the AIC costs for the third level of appeals, the Administrative Law Judge (ALJ) request, status quo at $180 for calendar year (CY) 2024, according to a notice in the Federal Register on Sept. 29.

However, after substantially bumping up AIC costs for judicial reviews, which are the fifth level of the Medicare appeals process, from $1,760 to $1,850 in 2023, you’ll be pleased to note that CMS decided to actually decrease the rate for next year. For CY 2024, the AIC for judicial review will stand at $1,840.

Why? The agency rounds the AIC threshold amounts to the nearest multiple of $10 after calculating results from federally-mandated percentage updates, CMS says. “The AIC threshold amount for judicial review changes to $1,837.02 based on the 83.702 percent increase over the initial threshold amount of $1,000. This amount was rounded to the nearest multiple of $10, resulting in the CY 2024 AIC threshold amount of $1,840.00 for judicial review,” reiterates CMS.