CMS Issues CERT Medicare Claims Error Rate for 2025

CMS; Medicare
 
Published:February 02, 2026
Dan Ciolek
​The Centers for Medicare and Medicaid Services has reported the national Medicare Fee-for-Service (FFS) improper payment rate in the FY 2025 HHS Agency Financial Report (section 3, Payment Integrity Report). The 2025 national Medicare FFS improper payment rate is 6.55%, or $28.83B in improper payments. See the FY 2025 Improper Payments fact sheet for more information. 

The projected improper payment amount for SNF services during the 2025 report period reported in the CMS supplemental CERT tables was $4.3 billion, resulting in an improper payment rate of 11.8 percent (down from 17.2 percent in FY 2024). Skilled nursing facilities (SNF) includes all services with a provider type of SNF, including SNF inpatient, SNF outpatient, and SNF inpatient Part B. The table excerpt below lists the top root causes for the reported SNF claims error rate in FY 2025. 

The image is a table detailing the top root causes for improper payments in Skilled Nursing Facilities (SNF), including insufficient documentation and missing information, totaling a projected improper payment amount of $4.3 billion for the 2025 period. AI-generated content may be incorrect.​