CMS MANUAL SYSTEM 
 
INTRODUCTION 
(Rev. 1, 10-01-03) 
 
 
Effective October 1, 2003, CMS will transition from a paper-based manual system for its 
manual instructions to a Web-based system.  The process includes the streamlining, 
updating, and consolidating of CMS various program instructions into an electronic 
Web-based manual system for all users.  The new system is called the online CMS 
Manual System and is located at http://www.cms.hhs.gov/manuals. 
The Online CMS Manual System is a replica of the official record copy. The official 
record copy is an electronic copy that is maintained by the Office of Strategic Operations 
and Regulatory Affairs, Division of Issuances, and is the official source document for the 
Agency.  This document takes precedence over the Web-based Internet-only manuals, if 
there are discrepancies noted.  As we update the program manual instructions, we will 
move that material into the new CMS Manual System and eliminate the corresponding 
material from the outgoing paper-based manuals.  We will continue this phase-out/phase-
in process until all manual instructions are included in the CMS Manual System.  In the 
meantime, you should check both sets of manuals for current policy and procedures.   
The current practice of issuing program memoranda (PMs) will be discontinued after 
September 30, 2003, and be replaced with one of four new vehicles/templates created to 
communicate program instructions and update the Web-based manual.  The new vehicles 
to communicate program instructions and update the new Internet-only manuals are (1) 
manual revisions, (2) one-time notification, (3) business requirement, or (4) confidential 
requirement templates.  The Office of Strategic Operations and Regulatory Affairs 
(OSORA), Division of Issuances, will continue its current policy of communicating 
advanced program instructions to the regions and contractor community every Friday.  A 
transmittal sheet will accompany all program instructions communicated by OSORA.  In 
addition, the transmittal sheet will identify changes pertaining to a specific manual, 
requirement, or notification. 
The new online CMS Manual System is organized by functional area, (e.g., eligibility, 
entitlement, claims processing, benefit policy, program integrity).  The functional 
orientation of the new manual eliminates significant redundancy within the manuals and 
streamlines the updating process, thus making CMS program instructions available in a 
more timely and accessible fashion. 
 
Specifically, the CMS Manual System will include the following functional areas: 
 
Pub. 100         Introduction   
Pub. 100-01--Medicare General Information, Eligibility, and Entitlement 
Pub. 100-02--Medicare Benefit Policy  Pub. 100-03--Medicare National Coverage Determinations 
Pub. 100-04--Medicare Claims Processing  
Pub. 100-05--Medicare Secondary Payer 
Pub. 100-06--Medicare Financial Management 
Pub. 100-07--Medicare State Operations 
Pub. 100-08--Medicare Program Integrity  
Pub. 100-09--Medicare Contractor Beneficiary and Provider Communications 
Pub. 100-10--Medicare Quality Improvement Organization 
Pub. 100-11--Reserved 
Pub. 100-12--State Medicaid 
Pub. 100-13--Medicaid State Childrens Health Insurance Program 
Pub. 100-14--Medicare End Stage Renal Disease Network Organization 
Pub. 100-15--Medicare State Buy-In 
Pub. 100-16--Medicare Managed Care  
Pub. 100-17--Medicare Business Partners Systems Security  
Pub. 100-18--Medicare Business Partners Security Oversight 
Pub. 100-19--Demonstrations 
Pub. 100-20--One-Time Notification 
 
However, the initial release will include Pub. 100, Pub 100-02, Pub 100-03,  
Pub. 100-04, Pub. 100-05, Pub 100-09, Pub 100.15 and Pub 100-20.   
 
The table below identifies what current paper-based manuals were used to construct the 
new Internet-only manuals.  It is just a cursory overview.  A detailed crosswalk is being 
developed to guide you from a specific section of the old manual to where the 
information now appears in the new manuals.  In addition, the Internet-only manual will 
have a crosswalk to show how the information in each section was derived. 
 
Paper-Based Manuals  Internet-Only Manuals 
   
Pub. 06--Medicare Coverage Issues  Pub. 100-01--Medicare General Information,   
Pub. 09--Medicare Outpatient Physical Therapy                        Eligibility, and Entitlement  
Pub. 10--Medicare Hospital  Pub. 100-02--Medicare Benefit Policy 
Pub. 11--Medicare Home Health Agency  Pub. 100-03--Medicare National Coverage  
Pub. 12--Medicare Skilled Nursing Facility                        Determinations 
Pub. 13--Medicare Intermediary Manual, Parts 1,  Pub. 100-04--Medicare Claims Processing 
2, 3, and 4  Pub. 100-05--Medicare Secondary Payer 
Pub. 14--Medicare Carriers Manual, Parts 1, 2, 3,  Pub. 100-06--Medicare Financial Management 
and 4  Pub. 100-08--Medicare Program Integrity 
Pub. 21--Medicare Hospice   Pub. 100-09--Medicare Contractor Beneficiary 
Pub. 27--Medicare Rural Health Clinic and  and Provider Communications 
Federally Qualified Health Center   
Pub. 29--Medicare Renal Dialysis Facility   
 
 
 
  Program Memoranda 
 
Pub. 60A--Intermediaries 
Pub. 60B--Carriers 
Pub. 60AB--Intermediaries/Carriers 
 
NOTE:  Information derived from Pub. 06 to 
Pub. 60AB was used to develop Pub. 100-01 to 
Pub. 100-09 for the Internet-only manual. 
 
   
Pub. 19--Medicare Peer Review Organization   Pub. 100-10--Medicare Quality Improvement 
Organization 
 
Pub. 07--Medicare State Operations  Pub. 100-07--Medicare State Operations 
   
Pub. 45--State Medicaid  Pub. 100-12--State Medicaid 
Pub. 100-13--Medicaid State Childrens Health 
Insurance Program  
   
Pub. 81--Medicare End Stage Renal Disease  Pub. 100-14--Medicare End Stage Renal 
Network Organizations  Disease Network Organizations 
 
Pub. 24--Medicare State Buy-In  Pub. 100-15--Medicare State Buy-In 
   
Pub. 75--Health Maintenance Organization/  Pub. 100-16--Medicare Managed Care 
Competitive Medical Plan 
Pub. 76--Health Maintenance Organization/ 
Competitive Medical Plan (PM) 
Pub. 77--Manual for Federally Qualified Health 
Maintenance Organizations 
Pub. 13--Medicare Intermediaries Manual, Part 2  Pub. 100-17--Business Partners Systems 
Pub. 14--Medicare Carriers Manual, Part 2    Security 
   
 
Pub. 13--Medicare Intermediaries Manual,   Pub. 100-18--Business Partners Security 
Part 2  Oversight 
Pub. 14--Medicare Carriers Manual, Part 2 
Demonstrations (PMs)  Pub 100-19 -- Demonstrations 
Program instructions that impact multiple  Pub 100-20 --One-Time Notification 
manuals or have no manual impact. 
 
Effective October 1, 2003, if a business requirement impacts a CMS program instruction 
contained in one of the manuals, the corresponding manual will also be updated and 
communicated along with the business requirement.  This information will be reflected 
on the transmittal sheet, which accompanies all changes to the manual.