Section title: Requests for Interpretation
RFI #
1732
Reporting the AMT T2
Description

When reporting tax amounts with the AMT in the 835, the text in 5010 for the T2 reads: “Use this monetary amount for the service charge before taxes. This is only used when there is an applicable tax amount on this service.”

Now the question:
The charged amount is $102 with AMT* T*2 and AMT*T2*100 (Assuming the provider sent both AMT segments). The payer reduces the line to $50 which reduces the tax to $1 and in theory the reported segments in the 835 would show a payment of $51 and both AMT segments to explain the tax. The AMT*T*1~ should be obvious, but because the wording in the 835 states “service charge before taxes”, should the AMT*T2 be $100 (service charge) or $50 (reduced price for service)?

RFI Response

The definition of the T2 qualifier for the AMT (both 2100 and 2110 loops) does not specify whether the amount included should be the original submitted amount or the adjudicated amount. Payers that are using this segment should define whether this amount is the original submitted amount or the adjudicated amount in their companion guides so that it is clear to their providers.

Usage of this segment will be evaluated for ongoing inclusion in future versions of the 835 TR3.

DOCUMENT ID
005010X221