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MSP (Medicare secondary payer)

Modified: 11/18/2024
Learn the answers to providers’ most frequently asked questions regarding how to bill MSP claims correctly.
Modified: 1/2/2025
The following questions originated from the "Medicare Secondary Payer (MSP) Educational Series." The questions are followed by the appropriate answer and the sources of the information are provided.
Modified: 12/17/2024
Read this article for an important change to MSP claim processing.
Modified: 11/29/2024
Read this article for more information on billing and coding your claims when Medicare is the secondary payer.
Modified: 11/29/2024
Use this article as a quick reference for billing claims where Medicare is the secondary payer.
Modified: 11/19/2024
Read this article for billing guidelines when Medicare is the tertiary payer.
Modified: 11/18/2024
Learn the answers to providers’ most frequently asked questions regarding how to bill MSP claims correctly.
Modified: 11/12/2024
Read the below article for more information on MSP ongoing responsibility for medicals.
Modified: 8/22/2024
Read this document for information on whether using Value Code 44 is appropriate for your claim.
Modified: 7/7/2024
Use this form to calculate estimated MSP payments for Part B of the Medicare program.
Modified: 5/22/2024
This article contains updated information for filing Medicare Part B secondary payer claims (MSP) in the 5010 format.
Modified: 5/18/2024
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary payer (MSP) claims.
Modified: 5/18/2024
Read this article to learn more about MSP claims in status location RB75XXX or PB75XXX.
Modified: 5/7/2024
This article contains important information about a revision being made to Medicare secondary payer (MSP) claim editing.
Modified: 4/29/2024
Read this article for more information on contacting the MSP Contractor.
Modified: 4/24/2024
Read this article for more information on how to bill claims when Medicare is the secondary payer. [IOM Pub 100-05 MSP Manual]
Modified: 4/19/2024
This questionnaire contains questions that can be used to help Medicare providers identify other payers that may be primary to Medicare.
Modified: 4/16/2024
Do you want to know how to avoid MSP claims payment delays and inappropriate denials? [WPC 837 IG; CMS IOM - MSP, Ch 5, Sec 50.1.8]
Modified: 4/14/2024
The purpose of the medicare secondary payer interactive billing tool simulation is to assist you with deciding if Medicare is the primary or secondary payer for certain types of MSP.
Modified: 4/14/2024
Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under the condition they are subject to repayment if and when the primary payer makes payment. [IOM Pub 100-05 MSP Manual]
Modified: 4/13/2024
Providers may file a Medicare secondary payer (MSP) claim and request a conditional payment for a Medicare-covered service when another payer is responsible for payment and is not expected to pay promptly (i.e., within 120 days). This article features a reference table that highlights the information that should be included within the MSP claim.
Modified: 4/12/2024
This article refers to denials when Medicare is the secondary payer during the coordination period of 30 months required for beneficiaries that are eligible for Medicare due to an ESRD diagnosis.
Modified: 4/12/2024
This article refers to denials when Medicare is the secondary payer during the coordination period of 30 months required for beneficiaries that are eligible for Medicare due to an ESRD diagnosis.
Modified: 4/11/2024
If Medicare eligibility shows open Medicare secondary payer (MSP) records, don't deny Medicare patients medical services, treatment, or entry to skilled nursing facilities or hospitals.
Modified: 4/10/2024
This article includes a quick reference table that will help the billing staff of providers, physicians, and other suppliers determine whether Medicare is the primary or secondary payer based upon specific situational criteria. The information included within the table is based upon the “Medicare Secondary Payer Fact Sheet” published by the Centers for Medicare & Medicaid Services (CMS).
Modified: 4/9/2024
Providers billing Medicare must determine if Medicare is the primary payer or not. This article has tips on checking MSP eligibility and avoiding MSP claim rejects.
Modified: 4/7/2024
View the Medicare Secondary Payer internet-only manual (IOM), Publication 100-05, on the Centers for Medicare & Medicaid Services (CMS) Internet-only manuals page.
Modified: 4/7/2024
The purpose of this fact sheet is to provide a general overview of the MSP provisions for individuals involved in the admission and billing procedures for health care providers, physicians, and other suppliers.
Modified: 2/21/2024
Please review this article for details on how to properly bill Medicare secondary payer (MSP) and conditional payment request claims on 837 institutional claims, and the use of occurrence code (OC) 24 and date of denial.
Modified: 11/10/2023
This article contains information for filing Medicare Part A secondary payer claims (MSP)
Modified: 5/2/2022
Use this calculator to determine a beneficiary's ESRD coordination period.
Modified: 8/3/2021
The purpose of the medicare secondary payer interactive billing tool simulation is to assist you with deciding if Medicare is the primary or secondary payer for certain types of MSP.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.