CMS Pub. 100-04, ch. 1, § 30.3.11

B3-3040.2

A receipted bill is a written acknowledgment by a person or organization furnishing

specified covered services, which states that payment has been made for all services on

the bill.

Where a receipted bill is submitted, benefits for the services shown on the bill should not

be paid to the physician (or his/her supplier) since there can be no assignment. (See §20)

The bill itself bearing the words “received payment,” “paid in full,” “paid,” or a phrase

with the same meaning, is the best evidence of payment if it is signed or initialed by the

physician (or his/her employee, etc.) or by the person or organization furnishing supplies

or services. There will, however, be other evidence of payment that will be acceptable,

such as machine-produced bills that clearly show the amount paid for each service. A

rubber-stamp imprint on the bill which includes the name of the physician or other

supplier is acceptable, absent a reason to question it. It is also reasonable to accept, as

evidence of payment, a cancelled check that is related in time and amount to a doctor’s,

or other Part B supplier’s bill.

A bill paid by promissory note is treated as a “receipted bill” unless the bill shows on its

face that the note is not given and accepted unconditionally as payment of the bill. For

example, a bill marked “paid by promissory note” or “$25 paid in cash, balance paid by

promissory note” is treated as a receipted bill. On the other hand, a bill marked “paid

subject to payment on promissory note,” or which otherwise clearly indicates that the

promissory note was not unconditionally accepted in payment of it, is not a receipted bill.