"Practice Administration" Information
Resource for Medicare

Join the Physicians Listserv

HighLights

Medlearn Matters...Information for Medicare Providers: articles designed to help providers understand new or changed Medicare policy.
Subscribe to the Medlearn Matters electronic mailing list

Payment/Billing:

Download free billing software and other CMS payment files here!
Medicare Payment Systems
Physician Fee Schedule: Informational materials related to the Medicare Physician Fee Schedule, including regulations, payment and data files.
Medicare Physician Fee Schedule Look-up: View physician service information, geographic practice cost indices and payment policy.
Sustainable Growth Rate: For Medicare Payments to Physicians
Electronic Funds Transfer (EFT)
Medicare Paper Claims: Forms and Instructions

Medicare Modernization Act (MMA)

Medicare Modernization Act
- Medicare Drug Card Ad Campaign (English / Espa�ol)
- Chronic Care Improvement Program
- Medicare-Approved Prescription Drug Discount Card Program
- Regional Medicare PPOs and PDPs Under the Medicare Modernization Act (coming soon)
- Medicare Modernization Act (MMA) State Fact Sheets
Medicare Modernization Update

Medicare Secondary Payer:

Coding:

Documentation Guidelines for Evaluation and Management Services
National Correct Coding Initiative Edits
- CCI Edits Educational Information
Healthcare Common Procedure Coding System
ICD-9-CM Diagnosis and Surgical Codes
- ICD-9 Conversion Table: A conversion table for diagnostic and procedural code changes between 1986-2004 is provided to assist users in data retrival. The table shows the date the new code became effective and its previously assigned code equivalent.
Web/Computer-based Training on Medicare Diagnosis Coding (ICD-9-CM)
Clinical Lab and DME Coding Procedures

Enrollment:

Medicare Physician Enrollment

Participation:

About Medicare Participation: Information about accepting assignment; includes the CMS form 460.(PDF Format 124kb)
Participating Physician Directory: Medicare�s national participating physician directory
Excluded Provider Database: From the OIG

HIPAA:

Compliance/Medical Review:

Medicare Integrity Program
Fighting Fraud and Abuse
Medicare Medical Review Program
Medicare Program Integrity Manual: Reflects the principles, values, and priorities for the Medicare Integrity Program (MIP)
OIG Compliance Guidance for Physician Practices (pdf format 96Kb)
OIG Fraud Prevention
Physician Self-Referral (STARK)
State Physician Self-Referral Laws
Clinical Laboratory Improvement Act (CLIA)

Grants/Demonstrations:

Rural/Urban:

Education:

Frequently Asked Questions (FAQS)
Medicare Learning Network: Using the Internet as a Learning Resource
- Satellite Broadcasts
- Order Form for Education and training Products
- Join the Medlearn Listserv
Medlearn Matters: Information for providers - Consistant materials for contractor outreach for Medicare providers.
- CR3129; see also Related Medlearn Matter article
Open Door Forums: Groups of Interest to those Individuals and Entities who Interact Regularly with CMS
Advance Beneficiary Notice
Limited English Proficiency/Translator Services Requirements
Medicare Resident & New Physician Guide: Helping Health Professionals Navigate Medicare. Seventh Edition 2003; Now Available
Medicare Drug Web Page
Press Releases: CMS Media Release Search

Medicare Coverage:

Medicare Coverage Database: Contains National Coverage Determination (NCDs), Analyses(NCAs), and Local Medical Review Policy (LMRPs)
Medicare Coverage Policy: Covering Existing National Coverage Policy
Medicare Coverage Issues Manual
Preventive Services: Information on Various Activities Geared Toward Disease Prevention and Health Promotion

Policies and Regulations:

CMS-0045-F - HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers (pdf format 249Kb)
Update for Physicians
Physician Fee Schedule
Update for Other Providers
Physician Supervision Levels: For 2003, found in column Z of RVU files
Physicians Regulatory Issues Team (PRIT)

Manuals:

Internet Only (Preferred)
Carrier (Pub. 14)
Other
Please Note:
Two other sites may have useful information and may include documents that reflect current policies and procedures not yet incorporated into these manuals. See: Program Manuals and Program Transmittals

Specialty-Specific Resources:

Provider Types -- All pages include specialized links to Federal Regulations, Program Transmittals, FAQs and ListServs.

Contacts:

Intermediary & Carrier Directory
- Map to Carrier/FI Toll Free Numbers

Note: Some of the files on this page are available only in Adobe Acrobat - Portable Document Format (PDF). To view PDF files, you must have the Adobe Acrobat Reader (minimum version 5, version 6 suggested). You can check here to see if you have the Acrobat Reader installed on your computer. If you do not already have the Acrobat Reader installed, please go to Adobe's Acrobat download page now.

Last Modified on Thursday, September 16, 2004

Search Frequenty Asked Questions

"Practice Administration" Information Resource for Medicare

HighLights

"Practice Administration" Information
Resource for Medicare