Medicare HETS - MSG Segments for Medicare Beneficiary Address of Record -7/15/2025

Medicare HETS 270/271 Submitters:

The Centers for Medicare & Medicaid Services (CMS) made an important update in January 2025 to how the HETS system handles Medicare beneficiary addresses in eligibility 271 responses.

Background:

• CMS gets Medicare beneficiary addresses from either the Social Security Administration (SSA) or Railroad Retirement Board (RRB)
• Usually, these addresses can be formatted properly in the standard 271 2100C N3/N4 format
• Sometimes, the address data from SSA or RRB doesn’t align with the 271-standard address, city, state, and zip code format to allow successful processing by software translators  

What's New: When an address can't be formatted properly, HETS now:

1. Puts "Refer to MSG for Subscriber address" in the 271 2100C N301 value
2. Includes the actual SSA or RRB address in a separate 271 2110C MSG01 segment labeled "Subscriber address"
3. Also provides a default Baltimore, MD 21244 address in 271 2100C N4 segment to meet technical requirements

What HETS Trading Partners Can Do:

• Update their systems to read address information from both the standard format AND the new message format
• Make sure they're providing complete address information to their customers
• This will help beneficiaries get services when 271 address information is needed

Important Reminder: If there are errors in a Medicare beneficiary's name, address, or date of birth, the beneficiary needs to contact SSA or RRB to fix it.

More information is available in the documents below.