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US · guidance

CMS Pub. 100-04, ch. 20, § 110.1

Billing/Claim Formats

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

The DME MAC and the A/B MAC (B) are billed on the ASC X12 837 professional claim

format or if permissible Form CMS-1500.

The A/B MAC (A) (including the A/B MAC (HHH)) is billed on the ASC X12 837

institutional claim format or if permissible Form CMS-1450.

Note that the ASC X12 formats support reporting of the CMNs in the FRM segment

The National Council for Prescription Drug Programs (NCPDP) Telecommunications

Standard Version D0 and Batch Standard 1.2 is the HIPAA standard for electronic retail

pharmacy drug claims and related coordination of benefits (COB).

This standard will be used by all DME MACs that process retail pharmacy drug

transactions. All other claims submitted to the DME MAC by pharmacies, other than

retail pharmacy drug claims, must be sent in the ASC X12 837 professional claim format.

History

(Rev. 2993, Effective: ASC X12 - 01-01-12, ICD-10 - Upon Implementation of ICD- 10; Implementation: ASC X12 - 08-25-14, ICD-10 - Upon Implementation of ICD- 10)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
632377ec02147ea6310cf660218b38ee63ef5da5bac4ba5bcbbbba23904f9646
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