US · guidance

CMS Pub. 100-04, ch. 24, § 40.1

Centers for Medicare and Medicaid Services - Medicare Fee-For-

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

Service

(Rev. 13105; Issued- 04-10-25; Effective: 05-12-25; Implementation: 05-12-25)

A/B MACs, DME MACs along with the Common Electric Data Interchange (CEDI)

contractor must transact versions of the institutional and professional claim (ASC X12

837 claim, institutional, professional and dental), the remittance advice (ASC X12 835

remittance advice), the claim status request and response (ASC X12 276/277 claim status

request and response), the eligibility inquiry and response (ASC X12 270/271 eligibility),

and the newly adopted error handling transactions (the ASC X12 277 CA claim

acknowledgment, the ASC X12 999 implementation acknowledgment and the ASC X12

TA1 interchange acknowledgment) within national standards developed by ASC X12.

CEDI must transact versions of the National Council for Prescription Drug Programs

(NCPDP) claims transactions.

Medicare FFS supports EDI as exchanged between all covered entities and Medicare FFS

contractors. This chapter provides guidance on how these relationships and the

transactions generated by them shall be established, maintained and managed.

History

(Rev. 13105; Issued- 04-10-25; Effective: 05-12-25; Implementation: 05-12-25)

Provenance

Source: cms.gov
Retrieved: 2026-08-25
Edition: iom-2026-08-25
Content hash: 9a4f8b0e52018d14fcfb450377a14fef369c41abe0cb58bf7b49cc2a16bfbb1a

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