CMS Announces 2027 Recovery Threshold

As required by section 1862(b) of the Social Security Act, CMS is required to review collection costs and publish an annual recovery threshold for liability, no-fault, and workers’ compensation settlements each year. This threshold amount reflects an amount for which CMS will not spend more on collections than a claim is likely to yield.

CMS announced that until further notice the threshold for physical trauma-based liability insurance settlements will remain at $750. CMS will also maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals.

Therefore settlements of $750 or less do not need to be reported, and Medicare’s conditional payment amount related to these cases does not need to be repaid.

A link to the alert is posted on the Non-Group Health Plan Recovery page of cms.gov.