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Medicare Secondary Payer Calculator Tool

The Medicare Secondary Payer tool can be used to determine the claim payment calculations when Medicare is the secondary payer for services. The calculations are done by detail line item. If the calculation does not provide a paid amount, it is because the provider has contracted with the primary insurance company and is obligated to accept their allowed amount for the service.

How many line items are on the claim?
Does the provider accept assignment?

  

Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

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