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CMS Guidelines and Resources for Medicare Secondary Payer (MSP)

The Centers for Medicare & Medicaid Services (CMS) website and Internet Only Manuals (IOMs) provide the following MSP guidelines and resources.

Billing MSP

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 3External PDF

Black Lung Disease

Claim Submission

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 3External PDF, §§30.4, 40 and §50

Conditional Payment

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 3External PDF, §40.3.1

Consolidated Omnibus Budget Reconciliation Act (COBRA)

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §20.2

Coordination of Benefits Contractor (COBC)

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 4External PDF, §10

Data Match

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 4External PDF, §30

Diagnosis Codes Related/Unrelated to Non-GHP Claims

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 6External PDF, §40.10

Disability

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §30

End Stage Renal Disease (ESRD)

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §20

ESRD and COBRA

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §20.2

Group Health Plan (GHP)

Large Group Health Plan (LGHP)

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §§10.2 and 30.2

Liability Insurance

MSP Admission Questionnaire

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 3External PDF, §20

No-Fault Insurance

Overpayments

Right to Recovery

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §40.1

Updating MSP Information/Records

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 4External PDF, §10.2

Workers' Compensation

Working Aged

  • Medicare Secondary Payer Manual (CMS Pub. 100-05)
    Chapter 2External PDF, §10

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