The 2025 Medicare Fee-For-Service Improper Payments Report was just released. The report identified an estimated $28.8 billion in improper payments with a payment error rate of 6.55%, slightly down from last year. The report outlines findings related to services most frequently billed and paid in error and outlines the reasons for the errors such as medical necessity, incorrect coding, and insufficient documentation.
Some notable findings include:
We recommend reviewing the entire report. Services identified as having high error rates should be considered for inclusion in your 2026 compliance audit plan.
The 2025 Improper Payments Report can be found here: https://www.cms.gov/files/document/nov-2025-medicare-ffs-supplemental-improper-payment-data-2025922.pdf