Publication #
100-04
Title
Medicare Claims Processing Manual
Downloads
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Chapter 1 - General Billing Requirements (PDF) -
Chapter 1 Crosswalk (PDF) -
Chapter 2 - Admission and Registration Requirements (PDF) -
Chapter 2 Crosswalk (PDF) -
Chapter 3 - Inpatient Hospital Billing (PDF) -
Chapter 3 Crosswalk (PDF) -
Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) (PDF) -
Chapter 4 Crosswalk (PDF) -
Chapter 5 - Part B Outpatient Rehabilitation and CORF/OPT Services (PDF) -
Chapter 5 Crosswalk (PDF) -
Chapter 6 - Inpatient Part A Billing and SNF Consolidated Billing (PDF) -
Chapter 6 Crosswalk (PDF) -
Chapter 7 - SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule) (PDF) -
Chapter 7 Crosswalk (PDF) -
Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims (PDF) -
Chapter 8 Crosswalk (PDF) -
Chapter 9 - Rural Health Clinics/Federally Qualified Health Centers (PDF) -
Chapter 9 Crosswalk (PDF) -
Chapter 10 - Home Health Agency Billing (PDF) -
Chapter 10 Crosswalk (PDF) -
Chapter 11 - Processing Hospice Claims (PDF) -
Chapter 11 Crosswalk (PDF) -
Chapter 12 - Physicians/Nonphysician Practitioners (PDF) -
Chapter 12 Crosswalk (PDF) -
Chapter 13 - Radiology Services and Other Diagnostic Procedures (PDF) -
Chapter 13 Crosswalk (PDF) -
Chapter 14 - Ambulatory Surgical Centers (PDF) -
Chapter 14 Crosswalk (PDF) -
Chapter 15 - Ambulance (PDF) -
Chapter 15 Crosswalk (PDF) -
Chapter 16 - Laboratory Services (PDF) -
Chapter 16 Crosswalk (PDF) -
Chapter 17 - Drugs and Biologicals (PDF) -
Chapter 17 Crosswalk (PDF) -
Chapter 18 - Preventive and Screening Services (PDF) -
Chapter 18 Crosswalk (PDF) -
Chapter 19 - Indian Health Services (PDF) -
Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (PDF) -
Chapter 20 Crosswalk (PDF) -
Chapter 21 - Medicare Summary Notices (PDF) -
Chapter 21 - Medicare Summary Notices - English Exhibits (ZIP) -
Chapter 21 - Medicare Summary Notices - Spanish Exhibits (ZIP) -
Chapter 21 Crosswalk (PDF) -
Chapter 22 - Remittance Advice (PDF) -
Chapter 22 Crosswalk (PDF) -
Chapter 23 - Fee Schedule Administration and Coding Requirements (PDF) -
Chapter 23 Crosswalk (PDF) -
Chapter 24 - General EDI and EDI Support Requirements, Electronic Claims and Coordination of Benefits Requirements, Mandatory Electronic Filing of Medicare Claims (PDF) -
Chapter 24 Crosswalk (PDF) -
Chapter 25 - Completing and Processing the Form CMS-1450 Data Set (PDF) -
Chapter 25 Crosswalk (PDF) -
Chapter 26 - Completing and Processing Form CMS-1500 Data Set (PDF) -
Chapter 26 Crosswalk (PDF) -
Chapter 27 - Contractor Instructions for CWF (PDF) -
Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers (PDF) -
Chapter 28 Crosswalk (PDF) -
Chapter 29 - Appeals of Claims Decisions (PDF) -
Chapter 29 Crosswalk (PDF) -
Chapter 30 - Financial Liability Protections (PDF) -
Chapter 30 Crosswalk (PDF) -
Chapter 31 - ANSI X12N Formats Other Than Claims or Remittance (PDF) -
Chapter 31 Crosswalk (PDF) -
Chapter 32 - Billing Requirements for Special Services (PDF) -
Chapter 33 - Miscellaneous Hold Harmless Provisions (PDF) -
Chapter 34 - Reopening and Revision of Claim Determinations and Decisions (PDF) -
Chapter 35 - Independent Diagnostic Testing Facility (IDTF) (PDF) -
Chapter 36 - Competitive Bidding (PDF) -
Chapter 37 - Department of Veterans Affairs (VA) Claims Adjudication Services Project (PDF) -
Chapter 38 - Emergency Preparedness Fee-For-Service Guidance (PDF) -
Chapter 39 – Opioid Treatment Programs (OTPs) (PDF)