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How to Use Medicare and Medicaid Guide

Medicare Exclusions National and Local Coverage Determinations—Exclusions from Coverage

Prospective Payment Systems Inpatient Hospital PPS—Outpatient Hospital PPS— Critical Access and Other Excluded Hospitals— Inpatient Rehabilitation Facility PPS—Outpatient Rehabilitation Facility PPS—Long-Term Care Hospital PPS—Psychiatric Hospital PPS—End-Stage Renal Disease Program—Ambulatory Surgical Center Rates— Hospice Reimbursement—Home Health PPS—Skilled Nursing Facility PPS

Volume 2

Cost Reports Allowable Costs Cost Apportionment—Cost Finding PIP—Due Dates—Cost Limits Composite Payments End-Stage Renal Disease Appeals—Audits Provider-Based Physicians

Cost Reporting Instructions and Forms Billing Instructions Form CMS-1450

Volume 3

Billing Instructions Form CMS-1500 Billing Instructions

Miscellaneous Forms Medicare Claims Filing—Refunds—Limitation of Liability

Medicare Provider Agreements—Conditions of Participation

HIPAA Medical Data Privacy

Medicare Administration—Appeals—Miscellaneous

Medicare—Medicaid Fraud and Abuse—Stark—False Claims Act

Medicare Part C Medicare Advantage

Medicare Part D Medicare Prescription Drug Plans

Medicaid Eligibility Medical Care and Services Payment to Providers Administration and Financing

Volume 4

Medicaid State Plan Summaries Medicare Laws Medicaid Laws Related Public Laws

Volume 5

Regulations: Medicare and Medicaid Medicare Coverage Lists

Volume 6

  • e divisions in Volume 6 hold full text documents and index

them with reference to the topical divisions in Volumes 1 through 3: Current Developments Indexes and Finding Lists

Finding Lists Topical Index

Current Developments Documents Reports and Other Documents PRRB and CMS Administrator Decisions Other Administrative Decisions CMS Manual Revisions Transmittals Federal Register Adopted Regulations Federal Register Proposed Regulations Federal Register Notices and Other Issuances Cases

  • e final tab in Volume 6, Last Filing Instruction, is con-

venient storage for the current filing instruction.

Medicare and Medicaid Guide Finding ListTools Comparison

Subscribers to the internet version of the Medicare and Med- icaid Guide can locate comparable print Finding List materials under several menu lines. e chart below provides details on where the information and/or finding lists are located.

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