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CMS Medicare Internet-Only Manuals

100-04

CMS Pub. 100-04

Medicare Claims Processing Manual

Centers for Medicare & Medicaid Services

1 (Rev. 13593)General Billing Requirements 2 (Rev. 12423)Admission and Registration Requirements 3 (Rev. 13757)Inpatient Hospital Billing 4 (Rev. 13702)Part B Hospital (Including Inpatient Hospital Part B and OPPS)5 (Rev. 11129)Part B Outpatient Rehabilitation and CORF/OPT Services 6 (Rev. 13089)Inpatient Part A Billing and SNF Consolidated Billing 7 (Rev. 10880)SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule)8 (Rev. 12979)Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims 9 (Rev. 13547)Rural Health Clinics/Federally Qualified Health Centers 10 (Rev. 13089)Home Health Agency Billing 11 (Rev. 13190)Processing Hospice Claims 12 (Rev. 13316)Physicians/Nonphysician Practitioners 13 (Rev. 13150)Radiology Services and Other Diagnostic Procedures 14 (Rev. 11927)Ambulatory Surgical Centers 15 (Rev. 13464)Ambulance 16 (Rev. 13746)Laboratory Services 17 (Rev. 13255)Drugs and Biologicals 18 (Rev. 13709)Preventive and Screening Services 19 (Rev. 11427)Indian Health Services 20 (Rev. 12557)Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)21 (Rev. 13380)Medicare Summary Notices 22 (Rev. 11427)Remittance Advice 23 (Rev. 13610)Fee Schedule Administration and Coding Requirements 24 (Rev. 13105)General EDI and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims 25 (Rev. 12423)Completing and Processing the Form CMS-1450 Data Set 26 (Rev. 12779)Completing and Processing Form CMS-1500 Data Set 27 (Rev. 13314)Contractor Instructions for CWF 28 (Rev. 13314)Coordination With Medigap, Medicaid, and Other Complementary Insurers 29 (Rev. 12423)Appeals of Claims Decisions 30 (Rev. 12934)Financial Liability Protections 31 (Rev. 10236)ANSI X12N Formats Other Than Claims or Remittance 32 (Rev. 13709)Billing Requirements for Special Services 33 (Rev. 739)Miscellaneous Hold Harmless Provisions 34 (Rev. 4219)Reopening and Revision of Claim Determinations and Decisions 35 (Rev. 4473)Independent Diagnostic Testing Facility (IDTF)36 (Rev. 11427)Competitive Bidding 37 (Rev. 11427)Department of Veterans Affairs (VA) Claims Adjudication Services Project 38 (Rev. 10135)Emergency Preparedness Fee-For-Service Guidance 39 (Rev. 13572)Opioid Treatment Programs (OTPs)