Financial

Financial related regulations can be found in many CMS Manuals as well as MLN Matters related to therapy CAPS, consolidated billing, various fee schedules and HIPPS codes to name a few.  Here you will find the most important CMS Manuals and latest transmittals at your fingertips as well as information on audit standards including CERT, MACs, MICs, PEPPER, Perm, RACs and ZPICs.

 
 CategoryDescription
100-01 Medicare General Information, Eligibility, and Entitlement Manual CMS Manual 100-01 Chapters and Corresponding Transmittals
100-02 Medicare Benefit Policy Manual

CMS Manual 100-02 Chapters and Corresponding Transmittals

100-04 Medicare Claims Processing Manual CMS Manual 100-04 Chapters and Corresponding Transmittals
100-06 Medicare Financial Management Manual CMS Manual 100-06 Chapters and Corresponding Transmittals
100-08 Medicare Program Integrity Manual CMS Manual 100-08 Chapters and Corresponding Transmittals
100-12 State Medicaid Manual

Informational and Procedural Material Needed by the States to Administer the Medicaid Program

100-15 Medicaid Program Integrity Manual

CMS Manual 100-15 Chapters and Corresponding Transmittals

100-16 Medicare Managed Care Manual

CMS Manual 100-16 Chapters and Corresponding Transmittals

Alternative Payment Models

Information on the development of new patient care payment models

Billing Compliance

Included are: audit standards, fact sheets, FAQs, program updates and other information on CERT, MAC, MIC, PEPPER, PERM, RA and ZPIC audits.

Billing Guides and Information

CMS Information and Guidelines for Billing

SNF Quality Reporting Program

The improving Medicare Post-Acute Care Transformation Act of 2014

SNF Value-Based Purchasing Program

Information on the quality and efficiency of health care


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