Medicare Administrative Contractors

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What entity will assist and serve MFTs and counselors in the enrollment process?

Medicare Administrative Contractors (MACs) for your state will be the primary source of contact in the process.

Here is a list of MACs by state and region:

https://www.cms.gov/Medicare/Medicare-Contracting/Medicare-Administrative-Contractors/Downloads/MACs-by-State-June-2019.pdf

What is a Medicare Administrator Contractor and what are their responsibilities?

Medicare Administrative Contractors (MACs) are private health care insurers that has been awarded a geographic jurisdiction by the Centers for Medicare and Medicaid Services (CMS) to process Medicare Part A and Part B medical care and mental health claims for Medicare Fee-For-Service (FFS) beneficiaries. CMS relies on a network of MACs to serve as the primary operational (intermediary) contact between the Medicare FFS program and the providers enrolled in the program. MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims.

What Specific Services do MACs provide to practitioners?

Key services that MACs perform include:

Enrolling providers in the Medicare FFS program
Processing Medicare FFS claims
Handling provider reimbursement services
Responding to provider inquiries
Educating providers about Medicare FFS billing requirements
Establishing local coverage determinations (LCD’s)

Providers enroll in Medicare through their designated MAC. You can find your designated MAC and their contact information and mailing address here: https://www.cms.gov/medicare/provider-enrollment-and-certification/medicareprovidersupenroll/downloads/contact_list.pdf