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US · guidance

CMS Pub. 100-05, ch. 5, § 70.3.1.6

Bills for Federal Government Programs

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

A. Value Codes and Amounts: FLs 39 thru 41

The following two value codes and amounts should be completed to show the type of

other coverage and the amount paid by the other payer for Medicare covered services:

• 16 - PHS, other Federal agency; and,

• 41 - Black lung.

History

(Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7298dda1f6b77ab9c0c283e0d6379e5563a4f35d664246ff607c74bf30bc363c
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