Helpful Auditing Resources and Links

CMS Medicare Billing-Related Sites – General

Provider Center
Beneficiary Notice Initiative (Including ABN Forms)
Comprehensive Error Rate Testing Home Page (CERT) – Overview Page
Chart Series (CMS Statistics)
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)
Departmental Appeals Board
DME Center
EHR Incentive Programs
Enrollment (Provider and Supplier) – Overview Page
esMD Electronic Submission of Medical Documentation
Evaluation and Management Services Guide
Frequently Asked Questions Database
Forms – CMS Downloads
Manuals – Internet Only Manuals
Manuals – Paper Based Manuals
Medicaid RAC
Medically Unlikely Edits Information
Medicare Administrative Contractors (MAC) Jurisdictions
Medicare Contractor Reform
Medicare Advantage Appeal Contractor
Medicare Advantage Out of Network Payment Guide
Medicare Advantage Payment Dispute Resolution Contractor
Medicare Home Page (Including Payment Systems)
MLN Publications
MLN Matters Articles – Overview Page
National Provider Identifier (NPI) – Overview Page
National Provider Identifier (NPI) Registry
Office of Medicare Hearings and Appeals
Open Door Forums – Overview Page
Prescription Drug Coverage – General Information
Press Releases and Other Media Releases
Quality Initiatives – General Information
Quarterly Provider Updates- Overview Page
Recovery Audit Program
Regional Office List
Taxonomy Codes
Transmittals – Overview Page (including Program Memoranda)

CMS Medicare Billing-Related Sites – Hospital Specific

APC Offset List
Hospital Center
Device-Related Procedure Edits
Diagnostic Radiopharmaceuticals Edits
Direct Graduate Medical Education (DGME) Information
Disproportionate Share Hospital (DSH) Information
Hospital-Acquired Conditions (Present on Admission Indicator) – Overview Page
Hospital Inpatient Quality Reporting Program
Hospital Outpatient Quality Reporting Program
IPPS – FY2012 Final Rule Home Page
IPPS – Home Page
IPPS – Pricer
IPPS – Regulations and Notices
National Correct Coding Initiative (NCCI) – Hospital Outpatient PPS
OCE Specifications
OPPS – Addendum A&B
OPPS Home Page
OPPS – Pricer 
OPPS – Regulations and Notices
PEPPER (Program for Evaluating Payment Patterns Electronic Reports)
Psychiatric Facility Inpatient Prospective Payment System
QualityNet Main Page
Revenue Code to Cost Center Crosswalk
Three Day Payment Window Information
Wage Index Files

CMS Medicare Billing-Related Sites – Physician/Practitioner Specific

Physician Center
Practice Administration Center
National Correct Coding Initiative – Carrier
Physician Bonuse – HPSA
Physician Fee Schedule – Online Lookup
Physician Fee Schedule – Overview Page

OIG Sites

Health Care Fraud Prevention and Enforcement Action Team (HEAT)
OIG Home Page
Special Fraud Alerts, Bulletins and Guidance

Regulations and Statutes

Code of Federal Regulations (Federal Regulations)
CFR Title 42 – Electronic Version
Federal Register
GPO FDSys (Federal Digital System) Home Page
Open Congress
Social Security Act, Title 18 (Medicare) – Public Laws
United States Code (Federal Statutes)


We welcome new members interested in this rewarding field of healthcare financial auditing. Gain access to research, networking with other audit professionals, and ongoing education.

Memberships are based on a calendar year, January 1 through December 31.

Renew your membership!

Member Login