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Availability of Medicare & Medicaid Manuals

CMS is undertaking an effort to provide electronic versions of the Paper-Based Manuals and the CMS Manual System on our web site.
Given limited resources, we will make as many of the manuals available as soon as possible.


Section 1 General Information
 
  • Who is eligible to receive CMS Manuals?
  • How to obtain a copies of CMS manuals/transmittals
  • Manuals sold by the GPO/Superintendent of Documents
  • Manuals sold by the National Technical Information Service
  • Section 2 Medicare Manuals
    Section 3 Medicaid Manuals
    Section 4 Program Memoranda
    Section 5 National Correct Coding Manual
    Section 6 Federal Depository Library Program

    Section 1 - General Information

    Who is eligible to receive CMS Manuals? How to obtain a copy of CMS manuals/transmittals?

    Medicare/Medicaid manuals, interim manual instructions, and Medicare transmittals are distributed to intermediaries, carriers, CMS Regional Offices, Federal Agencies, State Agencies and Congressional Offices, on a daily basis, to those requestors submitting a letter or memorandum. Send Correspondence to the address listed below.

    All Medicare providers should contact their carrier and/or intermediary to obtain a copy(s) of Medicare/Medicaid manuals and transmittals.

    If you feel you are entitled to Medicare/Medicaid manuals for reasons other than the above, you may apply directly to CMS at the address listed below to find out if you are eligible. The FAX Number for correspondence is (410) 786-4786.

    Centers for Medicare & Medicaid Services
    ATTN:    Distribution Management Team
    Room SLL-12-06
    7500 Security Blvd.
    Baltimore, MD    21244-1850

    Where can the public and/or private sector (lawyers, doctors--Part B side, CPAs, private medical institutions not dealing directly with Medicare) obtain a copy of CMS' Medicare manuals/transmittals?

    1. Medicare manuals are available for purchase through the Government Printing Office/Superintendent of Documents, Washington, D.C. You may purchase any of these manuals by calling (202) 512-1800 to determine the current price(s) and to receive purchasing instructions.
    2. Superintendent of Documents
      U.S. Government Printing Office
      Washington, D.C. 20402-9325

    3. Medicare manuals are also available for purchase through the National Technical Information Service, Springfield, Virginia. If you wish to purchase any of these manuals, please call (800) 363-2068 or (703) 605-6060 to determine the current prices(s) and to receive purchasing instructions. Requestors should specify the subscription title, publication number, and order number being requested. CMS Program Memorandums: Pub. 60A/Intermediary, Pub. 60B/Carrier and Pub. 60A/B Intermediary/Carrier are also available through NTIS. (See Pages 5-15 for a list of manuals.) You can send a written request to:
    4. U.S. Department of Commerce
      National Technical Information Service
      Subscription Department
      5285 Port Royal Road
      Springfield, VA 22161


    Section 2 - Medicare Manuals

    Sold by the Government Printing Office and the National Technical Information Service (NTIS).

    The following CMS paper-based manuals are available through the Superintendent of Documents (Sup Docs), Subscription Entry, U.S. GPO, Washington, D.C. 20402. Also, Sup Docs subscription service includes the basic manuals and all revisions for approximately 1 year. If you wish to purchase any of these manuals, please call (202) 512-1800 to determine the current price(s) and to receive purchasing instructions. Requestors should specify the subscription title, serial number, and the list identification of the item(s) being requested.

    NOTE: All of these publications are also freely available for download from CMS Paper-Based Manuals.

    HOWEVER, the paper version is considered the official version and takes precedence if any discrepancies occur.


    TITLE: Coverage Issues Manual
    PUB: CMS Pub. 6
    GPO LIST ID: MCIA
    SUBSCRIPTION TITLE S/N: 917-012-00000-8
      This manual contains national coverage decisions and sets forth whether specific medical items, services, treatment procedures, or technologies can be paid for under the Medicare program.
     
    TITLE: Hospital Manual
    PUB: CMS Pub. 10
    GPO LIST ID: HMP
    SUBSCRIPTION TITLE S/N: 917-004-00000-5
      This manual is issued to hospitals participating in the Medicare program and contains the policies and procedures applicable to the delivery of hospital services, claims processing instructions, billing procedures, coverage requirements, and related Medicare matters.
     
    TITLE: Home Health Agency Manual
    PUB: CMS Pub. 11
    GPO LIST ID: HHAM
    SUBSCRIPTION TITLE S/N: 917-004-00000-5
      This manual provides the operating instructions needed by the Home Health Agency in dealing with patients, its intermediary and the regional and central offices of the Health Care Financing Administration.
     
    TITLE: Skilled Nursing Facility Manual
    PUB: CMS Pub. 12
    GPO LIST ID: SNFM
    SUBSCRIPTION TITLE S/N: 917-008-00000-1
      This manual delineates the providers' responsibilities for claims submitted on behalf of Medicare beneficiaries. It includes the claims information necessary and the requirements for services covered under the program.
     
    TITLE: Medicare Intermediary Manual - Claims Process, Part 3
    PUB: CMS Pub. 13-3
    GPO LIST ID: MIMA
    SUBSCRIPTION TITLE S/N: 917-006-00000-8
      This manual contains instructions and procedures for processing claims. This includes coverage limitations and coverage requirements. The beneficiary appeals process is included.
     
    TITLE: Medicare Carriers Manual - Claims Process, Part 3
    PUB: CMS Pub. 14-3
    GPO LIST ID: MCMB
    SUBSCRIPTION TITLE S/N: 917-003-00000-9
      This manual contains informational and procedural material the carrier needs for the efficient processing and payment of claims. This includes instructions dealing with coverage of services, bill review, reasonable charges, and other pertinent claims procedures.
     
    TITLE: Provider Reimbursement Manual
    PUB: CMS Pub. 15-1
    GPO LIST ID: PRM
    SUBSCRIPTION TITLE S/N: 917-007-00000-4
      This manual includes instructions on calculating Medicare payments to hospitals and skilled nursing facilities which are reimbursed under the prospective payment system as well as other providers which are reimbursed on a reasonable cost basis.

    Section 3 - Medicaid Manuals

    Sold by the National Technical Information Service (NTIS).

    The following Health Care Financing Administration (HCFA) program manuals are available through the National Technical Information Service, Springfield, Virginia. Also, you can subscribe and will be sent the basic manual with current updates and future updates as they are issued by HCFA. If you wish to purchase any of the manuals listed below, please call (800) 363-2068 or (703) 605-6060.

    NOTE: All of these publications are also freely available for download from CMS Paper-Based Manuals.

    HOWEVER, the paper version is considered the official version and takes precedence if any discrepancies occur.


    TITLE: State Medicaid Manual, Introduction, Basic
    PUB: CMS Pub. 45
    ORDER NUMBER: PB 87-954500
      This Medicaid Manual provides operating policies and procedures for Medicaid single State agencies and others charged with administering the program. This introduces the parts of the State Medicaid Manual. Its users consist mostly of State agencies.
       
    TITLE: State Medicaid Manual, State Organization, Part 2
    PUB: CMS Pub. 45-2
    ORDER NUMBER: PB 88-952300
      This manual covers organization and general administration, State personnel administration, and State fiscal administration. Correlates to: 42 CFR Parts 431, 432, 433, and 45 CFR Parts 201 and 213.
       
    TITLE: State Medicaid Manual, Eligibility, Part 3
    PUB: CMS Pub. 45-3
    ORDER NUMBER: PB 89-952400
      This manual contains general provisions, definitions, mandatory and optional coverage, categorically and medically needy, financial requirements, etc. Correlates to: 42 CFR Parts 435 and 436.
       
    TITLE: State Medicaid Manual, Services, Part 4
    PUB: CMS Pub. 45-4
    ORDER NUMBER: PB 88-952500
      This manual covers requirements and limits applicable to all services and specific services, definitions and general provisions. Correlates to: 42 CFR Parts 440, 441, 442, and 481.
       
    TITLE: State Medicaid Manual, Early and Periodic Screening, Diagnosis, and Treatment (EPSDT), Part 5
    PUB: CMS Pub. 45-5
    ORDER NUMBER: PB 89-952600
      This manual covers early and periodic screening, diagnosis, and treatment of individuals under age 21. Correlates to: 42 CFR Part 441.
       
    TITLE: State Medicaid Manual, Payment for Services, Part 6
    PUB: CMS Pub. 45-6
    ORDER NUMBER: PB 89-952700
      This manual covers payment for services, general provisions, payment methods, and upper limits. Correlates to: 42 CFR Part 447.
       
    TITLE: State Medicaid Manual, Quality Control, Part 7
    PUB: CMS Pub. 45-7
    ORDER NUMBER: PB 95-952800
      This manual covers all aspects of the quality control program. Correlates to: 42 CFR Part 431.
       
    TITLE: State Medicaid Manual, Program Integrity, Part 8
    PUB: CMS Pub. 45-8
    ORDER NUMBER: PB 87-952900
      This manual covers program integrity, Medicaid agency fraud detection and investigation program, disclosure of information by providers and fiscal agents, and exclusion by providers and suspension of practitioners. Correlates to: 42 CFR 455
       
    TITLE: State Medicaid Manual, Utilization Control, Part 9
    PUB: CMS Pub. 45-9
    ORDER NUMBER: PB 89-953000
      This manual covers utilization control in all Medicaid services, hospitals, mental hospitals, skilled nursing facilities and intermediary care facilities; utilization review plans and inspections of care in an ICF and institutions for mental diseases. Correlates to: 42 CFR Part 456.
       
    TITLE: State Medicaid Manual, Medicaid Management Information System, Part 11
    PUB: CMS Pub. 45-11
    ORDER NUMBER: PB 89-953100
      This manual covers Medicaid management information systems, functional requirements, performance review standards and criteria and general systems design. Correlates to: 45 CFR part 95.
       
    TITLE: State Medicaid Manual, State Plan Procedures and Preprints, Part 13
    PUB: CMS Pub. 45-13
    ORDER NUMBER: PB 89-953200
      This manual covers State plan procedures and State plan preprints. Correlates to: 45 CFR Parts 201, 204, and 205.5.
       
    TITLE: State Medicaid Manual, Medicaid Eligibility Determination and Information Retrieval System, Part 15
    PUB: CMS Pub. 45-15
    ORDER NUMBER: PB 89-953400
      This manual covers the Medicaid eligibility determination and information retrieval system. Correlates to: 42 CFR Part 433 Subpart C.

    Section 4 - Program Memoranda

    Sold by the National Technical Information Service (NTIS).

    The following Centers for Medicare & Medicaid Services (CMS) program manuals are available through the National Technical Information Service, Springfield, Virginia. Also, you can subscribe and will be sent the basic manual with current updates and future updates as they are issued by HCFA. If you wish to purchase any of the manuals listed below, please call (800) 363-2068 or (703) 605-6060.

    NOTE: All of these publications are also freely available for download from CMS Paper-Based Manuals.

    HOWEVER, the paper version is considered the official version and takes precedence if any discrepancies occur.


    TITLE: Program Memorandum, Medicaid State Agencies
    PUB: CMS Pub. 17
    ORDER NUMBER: PB 99-956200
       
    TITLE: Program Memorandum, Intermediaries
    PUB: CMS Pub. 60A
    ORDER NUMBER: PB 99-955500
      Communicates with intermediaries on subjects and issues not appropriate for the Medicare Intermediary Manual because they are not ongoing instructions.
       
    TITLE: Program Memorandum, Carriers
    PUB:  CMS Pub. 60B
    ORDER NUMBER: PB 99-955600
      Communicates with carriers on subjects and issues not appropriate for the Medicare Carriers Manual because they are not ongoing instructions.
       
    TITLE: Program Memorandum, Intermediaries/Carriers
    PUB: CMS Pub. 60 AB
    ORDER NUMBER: PB 99-955700
      Communicates identical information to intermediaries and carriers on subjects and issues not appropriate for the Medicare Intermediary or the Medicare Carriers Manuals because they are not ongoing instructions.
       

    Section 5 - National Correct Coding Manual information is available from the NTIS.


    Section 6 - Federal Depository Library Program information is available from the Government Printing Office.


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    Last Modified on Thursday, September 16, 2004