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US · guidance

CMS Pub. 100-04, ch. 17, § 100.2

Claims Processing Instructions for CAP Claims for the A/B

activein force · 2026-08-25 – presentas-observed

MACs (B)

(Rev. 1412, Issued: 01-11-08, Effective: 01-01-08, Implementation: 04-07-08)

The A/B MAC (B) shall not process CAP claims submitted for United Mine Worker or

Medicare Advantage or Railroad Board beneficiaries. A/B MACs (B) shall follow

normal procedures for the disposition of these claims.

A/B MACs (B) shall pay for the administration of the drugs for which physicians have

elected to receive under CAP. CAP claims are required to comply with Medicare rules

and requirements for modifiers and other supporting information unless specific

exceptions are made. The A/B MACs (B) shall process CAP claims from physicians per

the following instructions.

History

(Rev. 1412, Issued: 01-11-08, Effective: 01-01-08, Implementation: 04-07-08)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
856c6d0c0df16e7bba82696b472872b1bc20aba50fff68872364b1e1243aef0c
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