Medicare Secondary Payer (MSP)
Medicare is a secondary payer when the beneficiary is covered by group insurance, Workers' Compensation, or if other third-party liability (no-fault, liability, Federal Black Lung Program) applies. Refer to the following resources for additional information.
- Medicare Secondary Payer (MSP) Overview
- CMS Guidelines and Resources for Medicare Secondary Payer (MSP)
- Submitting Medicare Secondary Payer (MSP) Claims and Adjustments
- Billing MSP Claims With Value Code 44
- Federal Black Lung (BL) Program
- Medicare Payment for MSP Claims
- Medicare Secondary Payer (MSP) Billing & Adjustments quick resource tool
- Medicare Secondary Payer (MSP) Billing & Adjustments Online tool
For more information about Medicare Secondary Payer (MSP) provisions and billing requirements, refer to the following CMS and CGS resources:
CMS Resources
- Medicare Secondary Payer Web page
- Medicare Secondary Payer Fact Sheet
- Other Insurer Intake Tool
- CMS Guidelines and Resources for Medicare Secondary Payer (MSP)
- Claims Processing Medicare Secondary Payer (MSP) Policy and Procedures Regarding Ongoing Responsibility for Medicals (ORM) (MM8984)
- Instructions on utilizing 837 Institutional CAS segments for Medicare Secondary Payer (MSP) Part A Claims
- Clarification of Conditional Payment Policy for Liability, No-Fault and Workers' Compensation (MLN Matters article 7355)
- MLN7748519 – Medicare Secondary Payer: Don't Deny Services & Bill Correctly (cms.gov)
- Contact the Benefits Coordination & Recovery Center (BCRC)
- MSP provisions (including information about situations in which Medicare pays as secondary): CMS Medicare Secondary Payer Manual (Pub. 100-05), chapter 2
- MSP billing/claim submission requirements: CMS Medicare Secondary Payer Manual (Pub. 100-05), chapter 3
- Processing MSP Claims Related or Unrelated to an Accident or Injury for Non-GHP Claims with ICD-9-CM Diagnosis Codes 500-508 and 800-999 or Related ICD-10-CM Diagnosis Codes – Medicare Secondary Payer (MSP) Manual (Pub 100-05, Ch. 6, Section 40.10
- Coordination of benefits: CMS Benefits Coordination & Recovery Center (BCRC) web page
CGS Resources
Reviewed: 12.06.23