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Bulletins
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Manual Archives
 
 
For outdated manuals not listed here try selecting the manual archives link to the left of this page.

Provider Specific Billing Sections

Name Description
CMS-1500 Billing  CMS-1500 Billing Manual
Revision Date: 3/26/10
Sections Revised 2.5
Removed obsolete wording.
UB-04 Billing UB04 Billing Manual
Revision Date: 7/1/08
Section Revised: 2.11
Added information for billing HCPCS Drug Codes on Outpatient claims
Pharmacy Billing Pharmacy Billing Manual
Revision Date: 5/10/12
Section Revised: 2.1, 2.4,3.0
Updated the completion of the Pharmacy Claim Form - instructions for completion section. Appendix A - NCPDP Other Coverage Codes removed. Updated text including NCPDP Version 5.1 to Version D.Ø.
Dental Billing Dental Billing Manual
Revision Date: 02/12/09
Sections Revised: 2.3
Added required legal wording for use of ADA coding.

Common Sections

Name Description
General Policy DMAP policy applicable to all providers
General Billing Billing guidelines applicable to all providers
EVS Section Overview of the Electronic Verification System components

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Provider Specific Policy Sections

Name Description
ABI Waiver Provider Policy Specific DMAP policy related to the ABI Waiver Program
AIDS Waiver Provider Policy Specific DMAP policy related to the AIDS Waiver Program
Ambulance Provider Policy Specific DMAP policy related to emergency transportation services
Ambulatory Surgical Provider Policy Specific DMAP policy related to the Ambulatory and Free-Standing Surgical Centers
Assisted Living Provider Policy Specific DMAP policy related to the Assisted Living Waiver Program
Clinic Provider Policy Specific DMAP policy related to clinic services
Community Support Services Provider Policy Specific DMAP policy related to community support services covered under the Rehab Option
Dental Policy Provider Specific DMAP policy related to dental services
DME Policy Provider Specific DMAP policy related to Durable Medical Equipment
Elderly/Disabled Provider Policy Specific DMAP policy related to the Elderly and Disabled Waiver Program
EPSDT Policy Provider Specific DMAP policy related to the Early Periodic Screening Treatment and Diagnosis Program
Extended Pregnancy Policy Provider Specific DMAP policy related to the Smart Start Program
FSER Provider Specific DMAP policy related to free standing emergency rooms
FQHC Provider Specific DMAP policy related to federally qualified health centers
Home Health Policy Provider Specific DMAP policy related to home health services
Hospice Policy Provider Specific DMAP policy related to hospice services
Independent Laboratory Policy Provider Specific DMAP policy related to clinical lab services
Independent Therapist Policy Provider Specific DMAP policy related to services by an independent therapist
Inpatient Policy Provider Specific DMAP policy related to services in an inpatient hospital setting
Long Term Care Policy Provider Specific DMAP policy related to services defined as long term care
HCBS/DD Waiver Manual DMAP policy related to the Developmentally Disabled Waiver Program
Optician Policy Provider Specific DMAP policy related to optical services
Outpatient Policy Provider Specific DMAP policy related to services in an outpatient hospital setting
Part C Birth to Three Provider Policy Specific DMAP policy related to the Birth to Three Program
Pharmacy Policy Provider Specific DMAP policy related to pharmacy services
Practitioner Provider Specific DMAP policy related to providers defined as general practitioners
Prescribed Pediatric Extended Care Policy Provider Specific DMAP policy related to the PPEC Program
Private Duty Nursing Policy Provider Specific DMAP policy related to private duty nursing services
Rehabilitation Agency Provider Specific DMAP policy related to rehabilitation agency providers and their services.
Renal Dialysis Facility Policy Provider Specific DMAP policy related to renal dialysis providers and their services.
School Based Health Services Policy Provider Specific DMAP policy related to the (EPSDT) School Based Health Services Program