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Resources for Auditors



General Billing

Provider Center

Beneficiary Notice Initiative (Including ABN Forms)

Comprehensive Error Rate Testing Home Page (CERT) – Overview Page

Clinical Diagnostic Laboratory Fee Schedule – Overview Page

Clinical Diagnostic Laboratory NCD Manual

Clinical Laboratory Improvement Amendments (CLIA)

CMS Regulations and Guidance Page

Contact Information for CMS

Coverage Center (NCDs, NCAs, LMRPs/LCDs)

Coverage with Evidence Development (CED)

Departmental Appeals Board

DME Center

Drug SAD (Self-Administered Drug) Exclusion List

EHR Incentive Programs

End Stage Renal Disease (ESRD) Provider Center

Enrollment (Provider and Supplier) – Overview Page

esMD Electronic Submission of Medical Documentation

Frequently Asked Questions Database

Forms – CMS Downloads

HHS Employee Directory

Manuals – Internet Only Manuals

Manuals – Paper Based Manuals

Medically Unlikely Edits Information

Medicare Administrative Contractors (MAC) Jurisdictions

Medicare Contractor Interactive Map 

Medicare Advantage Appeal Contractor

Medicare Advantage Out of Network Payment Guide

Medicare Advantage Payment Dispute Resolution Contractor

Medicare Home Page (Including Payment Systems)

Medicare Secondary Payer Recovery Contractor (MSPRC)

MLN Connects Provider ENews

MLN Publications

MLN Matters Articles – Overview Page

National Provider Identifier (NPI) – Overview Page

National Provider Identifier (NPI) Enumerator Site

National Provider Identifier (NPI) Registry

Newsroom Center, Press Releases and Fact Sheets 

Office of Medicare Hearings and Appeals

Open Door Forums – Overview Page

Prescription Drug Coverage – General Information

Quality Initiatives – General Information

Quarterly Provider Updates- Overview Page

Recovery Audit Program

Regional Office List

Taxonomy Codes

Therapy Code List

Transmittals – Overview Page (including Program Memoranda)



Physician / Practitioner Billing



Other Medicare Links





LTC Billing





Other Regulatory Sites







HIPAA Sites

National Uniform Billing Committee (NUBC)

Official UB-04 Data Specifications Manual

WPC EDI Standards
(To Access Implementation Guides for the Transaction Standards)







Miscellaneous and ListServs