Part A Claims Practice Addresses

Part A Outpatient Prospective Payment System (OPPS) hospital providers can confirm that the practice addresses submitted on claims are an exact match to the Provider Enrollment, Chain, and Ownership System (PECOS) to help avoid/correct any Return to Provider (RTP) claims. This function is provided to ensure compliance with Change Requests (CRs) 9613 and 9907 as noted in MLN Matters® article SE19007.

Once this process is implemented, CMS will direct A/B MACs to permanently turn on two system edits to enforce the requirements in the CMS Medicare Claims Processing Manual (Pub. 100-04), chapter 1, section 170:

  • Reason Code 34977 (claim service facility address doesn't match provider practice file address)
  • Reason Code 34978 (off-campus provider claim line that contains a HCPCS must have a HCPCS modifier PN or PO)


To access the practice addresses associated with your Part A account:

  • Select the "Claims" tab.
  • Select the "Practice Addresses" sub-tab.

A list of addresses associated with your NPI and PTAN will display as they appear in PECOS. Ensure the service location address reported on your claim is an exact match.

NOTE:The practice addresses information is updated on a weekly basis. Please allow up to 10 business days after you receive confirmation for a new/revised practice location address to become available in myCGS.

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