Highlights

Stay Informed - Go to CMS Mailing Lists to join a provider specific listserv (or electronic mailing list service) to receive news from CMS.

Billing/Payment

• Acute Inpatient
• Critical Access Hospitals
• Hospital Outpatient
• Inpatient Rehabilitation Facility PPS
• Long-Term Care Hospital
• Inpatient Psychiatric Facility PPS
• Other Medicare Payment Systems and Coding Files

Electronic Data Interchange (EDI)(Billing) Medicare information on electronic transactions under HIPAA

Medicare Drug Web Page
This page provides drug pricing files, program transmittals for drugs, and program memoranda.

Public Use Files for Download

Transplant Centers

CMS Manuals and Transmittals

• CMS Manual System (Internet-Only Manuals) -- Effective October 1, 2003, CMS transitioned from a paper-based to a web-based manual system.
• Hospital Program Transmittals
• Program Memoranda
• Hospital and Intermediary Manual -- Crosswalks from Paper-Based Manuals to Internet-Only Manuals

Medicare National Coverage Determinations Manual

Enrollment/Participation/Certification

Medicare Hospital Enrollment

CMS 855 Enrollment Forms

Medicaid Provider Enrollment (pdf file 7Kb)

Medicare Conditions of Participation

Survey and Certification

Cost Reporting

Provider Reimbursement Manual (Pub 15)

Provider Reimbursement Review Board

Policies/Regulations

Medicare Modernization Act

Quarterly Provider Update -- Hospital Regulations Published This Quarter

CMS-1727-P Medicare Program; "Provider Reimbursement Determinations and Appeals"

• CMS-1727-P, (adobe pdf 319Kb) Published at the Office of the Federal Register June 25, 2004
• CMS-1727-P (Microsoft Word zipped 114Kb) On Display June 24, 2004

Health Insurance Portability and Accountability Act (HIPAA)

• CMS-0045-F - HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers

Emergency Medical Treatment and Labor Act (EMTALA) Homepage

Forms

Beneficiary Notices Initiative (BNI)

• Hospital ABN

CMS 855 Forms

Form 1450 (UB-92)

Form 1500

All CMS Forms

Coverage

Medicare Coverage Homepage

Medicare Coverage Database contains National Coverage Determination(NCDs), National Coverage Analyses(NCAs), and Local Medical Review Policy (LMRPs)

Medicare National Coverage Determinations Manual

Medicare Secondary Payer

Medicare Secondary Payer Manual

Medicare Coordination of Benefits

Coding

Healthcare Common Procedure Coding System (HCPCS)

Alpha-Numeric HCPCS File

ICD9-CM Coordination and Maintenance Committee

ICD-9-CM Diagnosis and Surgical Codes

ICD-9 Coding Resources on Medlearn Effective October 1, 2003

National Correct Coding Edits for Hospital Outpatient

Initiatives

Hospital Quality Initiative

Beneficiary Notices Initiative (BNI)

Preventive Services Homepage: information on various activities geared toward disease prevention and health promotion

Immunizations

Education

Medicare Learning Network (Medlearn): using the Internet as a learning resource

• Order Form for Education and training Products

Medlearn Matters...Information for Medicare Providers -- Articles are designed to help providers understand new or changed Medicare policy.

Program Integrity/Medical Review

Fighting Fraud and Abuse

Medicare Medical Review Program

Medicare Integrity Program

Contacts

Contact Your Carrier/FI
via Toll-Free Numbers and Websites -- A listing of the new toll free numbers that CMS has installed at Medicare contractor sites

Quality Improvement Organizations

CMS Regional Offices

Contacting the COBC

Organ Procurement Directory

• Excel Spreadsheet (zip file 124Kb)
• Adobe Acrobat File (pdf file 278Kb)

How to Stay Informed

The CMS Quarterly Provider Update

• Hospital Quarterly Provider Update

Go to CMS Mailing Lists to join a provider specific listserv (or electronic mailing list service) to receive news from CMS.

Hospital Open Door Forum

Press Releases: CMS Media Release Search

CMS Health Care Industry Market Update
A series of reports on the health care industry.