Conditional Payment

40.3 - Conditional Payment (Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23) To make a conditional payment, A/B MACs and DME MACs indicate conditional payment on the CWF, Part B Claim by placing a "C" in the "MSP code" field (field 97 of the CWF Part B Claim record.). Intermediaries indicate conditional payment on the CWF Inpatient/SNF Bill by placing zeros (0) in the "value amount" field (position 77b) along with the appropriate "value code." An MSP auxiliary record for the beneficiary with a "Y" validity indicator must be present. The CWF will reject the claim with error code 6805 when a claim for conditional payment is submitted and there is no matching MSP auxiliary record present.