- Publication #
- 100-04
- Title
- Medicare Claims Processing Manual
Downloads
- Chapter 1 - General Billing Requirements [PDF, 1MB]
- Chapter 1 Crosswalk [PDF, 458KB]
- Chapter 2 - Admission and Registration Requirements [PDF, 238KB]
- Chapter 2 Crosswalk [PDF, 355KB]
- Chapter 3 - Inpatient Hospital Billing [PDF, 2MB]
- Chapter 3 Crosswalk [PDF, 376KB]
- Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) [PDF, 1MB]
- Chapter 4 Crosswalk [PDF, 353KB]
- Chapter 5 - Part B Outpatient Rehabilitation and CORF/OPT Services [PDF, 369KB]
- Chapter 5 Crosswalk [PDF, 120KB]
- Chapter 6 - Inpatient Part A Billing and SNF Consolidated Billing [PDF, 447KB]
- Chapter 6 Crosswalk [PDF, 177KB]
- Chapter 7 - SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule) [PDF, 135KB]
- Chapter 7 Crosswalk [PDF, 97KB]
- Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims [PDF, 653KB]
- Chapter 8 Crosswalk [PDF, 333KB]
- Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers [PDF, 215KB]
- Chapter 9 Crosswalk [PDF, 198KB]
- Chapter 10 - Home Health Agency Billing [PDF, 856KB]
- Chapter 10 Crosswalk [PDF, 203KB]
- Chapter 11 - Processing Hospice Claims [PDF, 439KB]
- Chapter 11 Crosswalk [PDF, 104KB]
- Chapter 12 - Physicians/Nonphysician Practitioners [PDF, 1MB]
- Chapter 12 Crosswalk [PDF, 314KB]
- Chapter 13 - Radiology Services and Other Diagnostic Procedures [PDF, 352KB]
- Chapter 13 Crosswalk [PDF, 217KB]
- Chapter 14 - Ambulatory Surgical Centers [PDF, 293KB]
- Chapter 14 Crosswalk [PDF, 70KB]
- Chapter 15 - Ambulance [PDF, 487KB]
- Chapter 15 Crosswalk [PDF, 144KB]
- Chapter 16 - Laboratory Services [PDF, 405KB]
- Chapter 16 Crosswalk [PDF, 297KB]
- Chapter 17 - Drugs and Biologicals [PDF, 481KB]
- Chapter 17 Crosswalk [PDF, 118KB]
- Chapter 18 - Preventive and Screening Services [PDF, 1MB]
- Chapter 18 Crosswalk [PDF, 299KB]
- Chapter 19 - Indian Health Services [PDF, 401KB]
- Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) [PDF, 443KB]
- Chapter 20 Crosswalk [PDF, 256KB]
- Chapter 21 - Medicare Summary Notices [PDF, 1MB]
- Chapter 21 - Medicare Summary Notices - English Exhibits [ZIP, 2MB]
- Chapter 21 - Medicare Summary Notices - Spanish Exhibits [ZIP, 1MB]
- Chapter 21 Crosswalk [PDF, 427KB]
- Chapter 22 - Remittance Advice [PDF, 729KB]
- Chapter 22 Crosswalk [PDF, 89KB]
- Chapter 23 - Fee Schedule Administration and Coding Requirements [PDF, 1MB]
- Chapter 23 Crosswalk [PDF, 219KB]
- Chapter 24 - General EDI and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims [PDF, 1MB]
- Chapter 24 Crosswalk [PDF, 160KB]
- Chapter 25 - Completing and Processing the Form CMS-1450 Data Set [PDF, 471KB]
- Chapter 25 Crosswalk [PDF, 165KB]
- Chapter 26 - Completing and Processing Form CMS-1500 Data Set [PDF, 614KB]
- Chapter 26 Crosswalk [PDF, 46KB]
- Chapter 27 - Contractor Instructions for CWF [PDF, 1MB]
- Chapter 27 Crosswalk [PDF, 170KB]
- Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers [PDF, 621KB]
- Chapter 28 Crosswalk [PDF, 147KB]
- Chapter 29 - Appeals of Claims Decisions [PDF, 604KB]
- Chapter 29 Crosswalk [PDF, 1MB]
- Chapter 30 - Financial Liability Protections [PDF, 1021KB]
- Chapter 30 Crosswalk [PDF, 228KB]
- Chapter 31 - ANSI X12N Formats Other Than Claims or Remittance [PDF, 306KB]
- Chapter 31 Crosswalk [PDF, 83KB]
- Chapter 32 - Billing Requirements for Special Services [PDF, 795KB]
- Chapter 33 - Miscellaneous Hold Harmless Provisions [PDF, 74KB]
- Chapter 34 - Reopening and Revision of Claim Determinations and Decisions [PDF, 99KB]
- Chapter 35 - Independent Diagnostic Testing Facility (IDTF) [PDF, 104KB]
- Chapter 36 - Competitive Bidding [PDF, 241KB]
- Chapter 37 - Department of Veterans Affairs (VA) Claims Adjudication Services Project [PDF, 41KB]
- Chapter 38 - Emergency Preparedness Fee-For-Service Guidance [PDF, 51KB]
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