Medicare Secondary Payer (MSP) Manual 
Chapter 3 - MSP Provider Billing Requirements 
Crosswalk 
New  New  Int.  Carrier  HO  HHA  SNF  PMs  Description 
Chap  Section  Pub. 13  Pub. 14  Pub. 10  Pub. 11  Pub. 12 
3  10  A3-3491.14  B3-3328.15  HO-263.14  HHA-253.13  SNF-336.14    General 
3  10.1              Definitions of Provider of Service, 
Health Care Provider, and Supplier of 
Services 
3  10.2  A3-3491.7    HO-263.8  HHA-252.14  SNF-336.8    Limitation on Right to Charge a 
A3-3490.11  HO-264.14  HHA-253.8  SNF-335.14  Beneficiary 
A3-3497.8  HO-263.8   
IM3497.8  HO-264.14 
3  10.2.1  A3-3328.24            Right of Physician or Supplier to 
Charge Beneficiary 
3  10.3  A3-3682    HO-264.9  HHA-252.9  SNF-335.9    Situations in Which MSP Billing 
A3-3682.3  HO-469  HHA-494  SNF-569  Applies 
HO-472 
3  10.4  A3-3489.2C    HO-262.4  HHA-248.2  SNF-332.4    Provider Responsibility When a Request 
HO-262.10  HHA-251.4  SNF-334.2  is Received From an Insurance 
Company or Attorney 
3  10.5  A3-3489.2D  B3-3328.24C  HO-262.4  HHA-250.23  SNF-332.4    Provider Responsibility When Duplicate 
IM3497.9  HO-262.10  HHA-251.4  SNF-334.2  Payments Are Received 
HO-289.24  HHA-248.2 
HO-484.7  New  New  Int.  Carrier  HO  HHA  SNF  PMs  Description 
Chap  Section  Pub. 13  Pub. 14  Pub. 10  Pub. 11  Pub. 12 
3  10.6      HO-263.15  HHA-252.15  SNF-335.15    Incorrect GHP Primary Payments 
HO-264.15  SNF-336.15 
3  10.7  A3-3418.29    HO-264.3  HHA-252.3  SNF-335.3    Retroactive Application 
3  10.8              Medicare Health Maintenance 
Organization (HMO) Contracts 
3  20  A3-3490.12    HO-262.4  HHA-251.4  SNF-332.4  A-01-116  Obtain Information From Patient or 
A3-3491.4  HO-262.10  HHA-252.7  SNF-334.2  A-02-021  Representative at Admission or Start of 
A3-3418.4  HO-248.2  HHA-253.5  SNF-401  A-03-031  Care 
A3-3489.2  HO-263.5  HHA-341  SNF-335.7 
A3-3492D  HO-264.7  SNF-336.5 
HO-300  SNF-337 
HO-301 
3  20.1            A-02-021  General Policy 
3  20.2      HO-301.1        Verification of Medicare Secondary 
Payer (MSP) Online Data and Use of 
Admission Questions 
3  20.2.1      HO-301.2        Admission Questions to Ask Medicare 
Beneficiaries 
3  20.2.2      HO-301.3        Documentation to Support the 
Admission Process 
3  30              Provider Billing 
(Section heading only)  New  New  Int.  Carrier  HO  HHA  SNF  PMs  Description 
Chap  Section  Pub. 13  Pub. 14  Pub. 10  Pub. 11  Pub. 12 
3  30.1  A3-3491    HO-262.4  HHA-250.11  SNF-327    Health Care Provider Billing Where 
A3-3491.6  HO-263.1  HHA-251.4  SNF-332.4  Services Are Covered by a GHP 
A3-3491.6B  HO-263.7  HHA-252  SNF-335 
A3-3490  HO-264  HHA-252.9  SNF-335.9 
A3-3490.12B1  HO-264.9  HHA-253.1  SNF-336.1 
A3-3490.12B2  HO-289.11  HHA-253.7  SNF-336.7 
3  30.2  A3-3489.2B    HO-262.4  HHA-251.4  SNF-332.4    Provider Billing Where Services Are 
Accident Related 
3  30.2.1  A3-3489    HO-262.8  HHA-248  SNF-327.1    Health Care Provider Bills Automobile 
A3-3408.1B  HO-262.10  HHA-248.2  SNF-334  Medical or No-Fault Insurer First 
HO-262.14  HHA-248.6  SNF-334.2 
HO-289.12  HHA-250.12  SNF-334.8 
3  30.2.1.1  A3-3682.5A    HO-262.11  HHA-248.3  SNF-329    No-Fault Insurance Does Not Pay 
A3-3689.2  HO-289.14  HHA-248.2  SNF-334 
HO-262.10  HHA-250.14  SNF-334.2 
3  30.2.1.2  A3-3489.2B3    HO-289.5  HHA-250.14  SNF-329    Liability Claim Also Involved 
HO-289.14  HHA-250.5  SNF-325.5 
HO-262.10  HHA-248.2  SNF-334.2 
3  30.2.1.3  A3-3489.2B4    HO-262.10  HHA-248.2  SNF-334.2    No-fault Payment is Reduced Because 
Proper Claim Not Filed 
3  30.2.2  A3-3408.1A    HO-289.12  HHA-250.12  SNF-327.1     
A3-3408.2  HO-289.13  HHA-250.13  SNF-327.2  Responsibility of Provider Where 
A3-3408.4  HO-289.14  HHA-250.14  SNF-329  Benefits May Be Payable Under 
Workers' Compensation   
3  30.2.3  A3-3408.3    HO-289.14  HHA-250.14  SNF-329.3    Responsibility of Provider Where 
HO-289.18  HHA-250.18  SNF-329  Benefits May be Payable Under the 
Federal Black Lung (BL) Program  New  New  Int.  Carrier  HO  HHA  SNF  PMs  Description 
Chap  Section  Pub. 13  Pub. 14  Pub. 10  Pub. 11  Pub. 12 
3  30.3  A3-3492.E        SNF-337    Provider Billing Medicare for 
A3-3408  Secondary Benefits 
3  30.4            AB-03-011  Instructions to Providers On How to 
Submit Claims to a Medicare 
Intermediary When There Are Multiple 
Primary Payers 
3  30.5            AB-03-111  Instructions to Physicians and Suppliers 
On How to Submit Claims to a 
Medicare Carrier When There Are 
Multiple Primary Payers 
3  40  A3-3682    HO-264.9  HHA-494  SNF-335.9    Completing the Form CMS-1450 in 
HO-469  HHA-252.9  SNF-569  MSP Situations by Providers of Service 
HO-471  HHA-495  SNF-571 
HO-472  HHA-496  SNF-572 
HO-475  HHA-497  SNF-570 
HO-470 
3  40.1  A3-3682.1    HO-472.1  HHA-264.11  SNF-335.11    Full Payment by the Primary Payer 
A3-3682.3  HO-472.3  HHA-252.11  (Section heading only) 
3  40.1.1              Inpatient Services 
3  40.1.2  A3-3682    HO-264.9  HHA-494  SNF-335.9    Outpatient Bills, Part B Inpatient 
A3-3682.4  HO-469  HHA-252.9  SNF-569  Services, and HHA Bills 
HO-472.2 
3  40.2  A3-3682.1B    HO-263.11  HHA-253.11  SNF-336.11    Partial Payment by Primary Payer 
IM3497.2  HHA-264.10  SNF-335.10 
HHA-252.10  New  New  Int.  Carrier  HO  HHA  SNF  PMs  Description 
Chap  Section  Pub. 13  Pub. 14  Pub. 10  Pub. 11  Pub. 12 
3  40.2.1  A3-3682.1B    HO-472.3        Partial Payment by Primary Payer for 
Inpatient Services, Outpatient Services, 
Part B Inpatient Services, and HHA 
Bills 
3  40.2.2  A3-3682.2B    HO-264.9  HHA-252.9  SNF-335.9    Partial Payment by Primary Payer That 
A3-3682.2B3  HO-472  Applies to Medicare Covered Services 
A3-3682.1B5  HO-472.3 
A3-3682.3B5 
A3-3682.4B3 
A3-3682.5 
A3-3685.A2 
3  40.3  A3-3491.9D    HO-263.10  HHA-253.10  SNF-336.10    Annotation of Claims Denied by GHP's, 
A3-3682.5  HO-472.3  Liability or No-Fault Insurers 
3  40.3.1  A3-3682.5    HO-289.21  HHA-250.20  SNF-330    Annotation of Claims to Request 
Conditional Payments 
3  50              Summary of MSP Data Elements for 
Form CMS-1450 (UB-92) 
3  60    B3-4020.1          Completing the Form CMS-1500 in 
MSP Situations by Suppliers of Service