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Medicare Advantage Encounter Data and RAPS Data
FAQs

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Where can MAOs and other entities access the Risk Adjustment for EDS & RAPS User Group materials?03/31/2020
Where can MAOs submit questions about RAPS and other risk adjustment issues?03/31/2020
Are encounter data records and chart review records with default NPIs for atypical providers considered for risk calculation?11/01/2019
How should MAOs report annual wellness visits to CMS?11/01/2019
How should an MAO Encounter Data Technical Contact ensure they are registered to receive HPMS communications?10/01/2019
If the MAO-002 comes back with the encounter accepted but some of the service lines rejected, should we consider the encounter as rejected, requiring a void and replacement of the whole encounter?10/01/2019
Will CMS publish a list of risk adjustment eligible CPT/HCPCS codes?10/01/2019
How should Medicare Advantage plans submit encounters for a supplemental gym membership?09/01/2019
How is the EDPS ICN assigned?08/15/2019
If MAOs submit an unlinked CRR that corresponds to an accepted EDR, will it result in a duplicate error?08/15/2019
Can a Linked Chart Review Record use either the HICN or MBI when matching to an encounter (if the encounter uses the other beneficiary identifier)?06/20/2019
Do Risk Adjustment filtering rules differ between PACE and typical Medicare Advantage plans?06/20/2019
How can MAOs securely submit PII or PHI so that CMS may research issues?06/20/2019
How should anesthesia claims with procedure code 01996 be submitted?06/20/2019
Where are the ICD-10 to HCC mappings located?06/20/2019
What is the cutoff time for RAPS and EDS submission deadlines?05/22/2019
For replacement and void encounter data, if one of the key data fields is different from the original claim submitted, should the encounter be submitted as an original?04/18/2019
How do MAOs and other entities access the CMS 5010 CEM Spreadsheet?03/21/2019
What connectivity options can MAOs and other entities use to submit RAPS and EDS files?03/21/2019
An MAO submitted a CRR Add that was linked to an original EDR. The linked CRR Add was accepted. The MAO then submitted a replacement of the EDR, and it was accepted. Because the linked CRR Add was submitted for the original EDR, will those CRR Add diagnoses now be linked to the replacement EDR?02/21/2019
Why do some diagnoses appear on the MAO-004 reports showing as accepted and allowed, but do not appear on the 2019 Initial payment MOR?02/21/2019
Does CMS use diagnosis codes submitted via an unlinked chart review for Risk Adjustment payments?01/17/2019
Since the transition to the new MBI on April 2, 2018, can MAOs and other entities submit deletions for dates of service (DOS) before April 2, 2018 using the HICN?01/15/2019
When deleting EDPS data, should plans use the same beneficiary identifiers (i.e. HICN or MBI) used to submit the original data?11/01/2018
Will the MAO-004 report contain DME encounter services?06/01/2018
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