Medicare Administrative Contractors (MAC) Jurisdictions
The Centers for Medicare & Medicaid Services (CMS) uses a network of contractors called Medicare Administrative Contractors to process Medicare claims, enroll health care providers in the Medicare program and educate providers on Medicare billing requirements. MACs also handle claims appeals and answer beneficiary and provider inquiries. Section 1861 of the Social Security Act (“the act”) defines the items and services for which Medicare may pay. It also defines the provider types recognized by the Medicare program.
Part A and Part B MACs
A/B MACs process Medicare Part A and Medicare Part B claims for a defined geographic area or “jurisdiction,” servicing institutional providers, physicians, practitioners, and suppliers. In April 2006, CMS began to award Medicare claims processing contracts through competitive procedures.
Through the initial series of A/B MAC procurements, Medicare's claims processing operations have realized significant operational savings from the consolidation of state workloads and the efficiencies gained through integrating Part A and Part B functionality. CMS believes that the efficiency and effectiveness of its contracted Medicare claims operations can be further increased by consolidating some of the smaller A/B MAC workloads to form larger A/B MAC jurisdictions. Additional details, Fact Sheet and Maps for the A/B MAC jurisdictions are available using the "Related Links" below.
Home Health and Hospice (HH+H)
In March 2007, CMS announced that the HH+H workloads would be consolidated into four of the A/B MAC contracts instead of being procured separately under Cycle Two. CMS integrated the four home health and hospice jurisdictional claims workloads into the following four A/B MAC competitions:
- Jurisdiction 6 included home health and hospice Jurisdiction D
- Jurisdiction 11 included home health and hospice Jurisdiction C
- Jurisdiction 14 included home health and hospice Jurisdiction A
- Jurisdiction 15 included home health and hospice Jurisdiction B
Additional details, Fact Sheets and Maps of the HH+H jurisdictions are available using the "Related Links" below.
Durable Medical Equipment (DME) MACs
DME MACs process Medicare claims for durable medical equipment, prosthetics, orthotics, and suppliers under Part B of the Medicare Fee-for-Service program for a defined geographic area or “jurisdiction.” The DME MACs will process claims based on a Medicare Beneficiary’s principal residence by state. During the initial DME implementation phase (2005 – 2011) CMS awarded contracts to four regional DME MACs. The four DME MACs processed claims for geographical areas or states that may be in more than one A/B MAC jurisdiction. For example, Jurisdiction D processes claims for those states in both Jurisdictions E and F. Additional details, Fact Sheets and Maps of the DME jurisdictions are available using the "Related Links" below.
Consolidation of the MACs
Originally, CMS proposed 15 regional A/B MAC jurisdictions to serve the nation as the foundation for CMS’s initial series of A/B procurements. Starting in 2010, CMS engaged in a MAC consolidation strategy to move from 15 A/B MAC jurisdictions to 10 A/B MAC jurisdictions in a phased approach. As of March 2014, CMS has achieved three (3) of the planned A/B MAC contract consolidations, and there are presently twelve (12) A/B MAC contract workloads. After due consideration of several current program trends, CMS has decided to postpone the final two A/B MAC contract consolidations for up to one additional MAC procurement cycle (5 years). For more details on the consolidation plan use this link MAC Postponement. The long-term Consolidated jurisdiction map can be accessed using the "Download" below.
Find Your MAC
MACs are assigned by State. The Link below will take you to an interactive map where you may find all of your MAC and other contractors assigned to your state.
Interactive Map >>> Find Your MAC
- Page last Modified: 02/02/2015 11:17 AM
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