On July 1, 2025, the Centers for Medicare & Medicaid Services (CMS) introduced several enhancements to the IDR Portal affecting how disputes are initiated, how health plan types are classified, and new validation requirements. Since then, CMS has just announced further enhancements addressing duplicate submission errors caused by these updates.
Fixing the duplicate dispute technical issue
After the July 1, 2025 updates, CMS identified a glitch that wrongly blocked certain disputes with matching core details but distinct modifiers, leading to temporary extensions for affected cases. This issue has now been resolved, with the introduction of the optional Service Code Modifier(s) field.
The Service Code Modifier(s) field allows initiating parties to enter up to four modifiers (such as 25;37;AI;GC), separated by semicolons, providing more precise differentiation for items or services. Now, a dispute is flagged as a duplicate only if it exactly matches the claim number, date of service, service code, and any provided modifiers. Exceptions include disputes previously closed due to cooling-off periods or those granted extensions by the Federal IDR Team.
IDR Entities can access this information through portal records, reports, and APIs, making eligibility reviews more accurate. For resubmissions involving improperly batched or bundled items, parties should use the dedicated Notice of IDR Initiation – Resubmission form, which bypasses the duplicate check entirely.
NOTE: As of October 31, 2025, extensions will no longer be available for previously impacted disputes or future ones where the field isn’t used properly, resulting in blocks. This emphasizes the need to include modifiers when applicable to avoid delays.
To support these changes, CMS has updated various resources, including user guides, demos, companion guides, and data dictionaries. These are available on the Registration for Technical Assistance Portal (REGTAP) and the Overview of Rules and Facts Sheets webpage.
We appreciate CMS’s responsiveness in addressing this technical challenge and its continued commitment to improving the IDR process for all stakeholders.
What This Means for You
These portal improvements should minimize administrative hurdles, allowing for quicker processing of valid disputes and better overall efficiency. We recommend always incorporating relevant modifiers during initiation to prevent unnecessary rejections. For batching-related resubmissions, rely on the specific Resubmission form. Additionally, to ensure access to the latest features amid ongoing updates, clear your browser cache or use incognito mode at least weekly when working in the portal.
As always, the FHAS Account Team is here to help navigate these changes. If you have questions about how these updates affect your specific situations or need assistance with dispute submissions, please don’t hesitate to contact our client services team at IDRE@fhas.com or 800-664-7177.
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