US · guidance
CMS Pub. 100-05, ch. 1, § 30.2
MSP Provider, Physician, and Other Supplier Billing Requirements
Chapter 3 of the Medicare Secondary Payer Manual, an outline of the
provider’s responsibility to gather information sufficient to identify primary
payers and to bill them before billing Medicare, if MSP provisions state
Medicare should be secondary payer. Identifying commensurable information
upon beneficiary admission can help prevent incorrect billing and Medicare
overpayments.
A/B MACs, DME MACs and the MSP Contractors are required in
professional and public relations activities to inform providers, physicians,
other suppliers, and beneficiaries about the MSP provisions and that claims
for services to beneficiaries for which Medicare is the secondary payer must
be directed first to the primary plan where there is primary coverage for the
services involved. The Medicare law and/or provider agreement require the
submitter to identify on the claim all known payers obligated to pay primary
to Medicare. See 42 CFR § 489.20.
History
(Rev. 11755, Issued:12-21-22, Effective: 01-23-23, Implementation: 01-23-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
769f3c034ac32192248c2143a36cfd316d1169c11b6c9a81690c8b257bd2aa95
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