CMS Pub. 100-04, ch. 1, § 70.8.3

Suppliers

(Rev. 12909; Issued: 10-24-24; Effective: 11-26-24; Implementation: 11-26-24)

The method of claiming Part B benefits depends upon whether the patient is claiming

payment or is assigning benefit payments to his/her source of medical treatment or

services.

As a rule, beneficiaries do not submit claims for reimbursement. However, if there is

reason for a beneficiary to submit a claim for reimbursement, the beneficiary uses the

CMS-1490S. For covered services furnished on or after September 1, 1990, physicians

and suppliers must complete and submit in accordance with SSA §1848(g)(4)(A) all Part

B claims whether assigned or unassigned for beneficiaries who desire Medicare benefit

payment determinations.

The physician/supplier or the facility or organization to which the physician may reassign

benefits, claims the payment. The patient or his representative agrees to assign the

benefits and the physician/supplier agreeing to the assignment accepts the Medicare

reasonable charge determination as the full charge for the services. (See §§30.2 through

30.3.8 about specific assignment procedures and the nature and effect of assignments.)