Medicare Benefit Policy Manual
The Medicare Benefit Policy Manual is a new manual that replaces current Medicare general coverage instructions that are not National Coverage Determinations. In general these instructions have been found in Chapter II of the Carriers Manual, Intermediary Manual, and the various provider manuals, and in Program Memoranda. Material from the Coverage Issues Manual is not in this manual but will be found in the National Coverage Determinations Manual.(Pub. 100-3).
New instructions will be published in this manual. Manual transmitals through Revision Transmittal Number 3, dated December 19, 2003, are included in this update. As new transmittals are included they will be identified on this page. To review individual transmittals, view the CMS Transmittal Web site.
A crosswalk from the new manual to the source manual instruction is provided with each chapter. This crosswalk for the entire chapter may be accessed from the chapter table of contents. Also, the crosswalk for each section is shown immediately under the section heading.
You may either view the file in PDF or download a zipped MSWord file.
| Chapter | Title | Open PDF File | Zipped Word File |
|---|---|---|---|
| One | Inpatient Hospital Services |  186 KB |
41 KB |
| Two | Inpatient Psychiatric Hospital Services | 139 KB |
14 KB |
| Three | Duration of Covered Inpatient Services | 132 KB |
13 KB |
| Four | Inpatient Psychiatric Benefit Days Reduction and Lifetime Limitation | 99 KB |
13 KB |
| Five | Lifetime Reserve Days | 95 KB |
21 KB |
| Six | Hospital Services Covered Under Part B | 243 KB |
26 KB |
| Seven | Home Health Services | 866 KB |
94 KB |
| Eight | Coverage of Extended Care (SNF) Services Under Hospital Insurance | 514 KB |
58 KB |
| Nine | Coverage of Hospice Services Under Hospital Insurance | 271 KB |
36 KB |
| Ten | Ambulance Services | 258 KB |
33 KB |
| Eleven | End Stage Renal Disease (ESRD) | 575 KB |
73 KB |
| Twelve | Comprehensive Outpatient Rehabilitation Facility (CORF) Coverage | 147 KB |
20 KB |
| Thirteen | Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services | 284 KB |
33 KB |
| Fourteen | Medical Devices | 152 KB |
17 KB |
| Fifteen | Covered Medical and Other Health Services | 1,426KB |
206 KB |
| Sixteen | General Exclusions from Coverage | 317 KB |
48 KB |
One Time Notifications
Business Requirements for Contractors
Confidential Requirements for Contractors
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