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CMS 1500 Provider Manual and Bulletins


CMS 1500 Provider Manual

CMS-1500 Provider Manual (Effecitve 1.6.17)
CMS-1500 Provider Manual (Effective 1.1.17)
Provider Medicaid and State Health Care Benefit Plan 1.1.17
Ordering, Referring, or Prescribing Provider Required on Claim
CMS-1500 Provider Manual Q4 2016 (Valid 10/1/16 - 12/31/16)
CMS-1500 Provider Manual Q3 2016 (Valid 7/1/16 - 9/30/16)
CMS-1500 Provider Manual Q2 2016 (Valid 4/1/16 - 6/30/16
CMS-1500 Provider Manual Q1 2016 (Valid 1/1/16 - 3/31/16)

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To search for specific information within the PDF document, select Ctrl F on your keyboard and type your keyword in the find box.


Important Policy Changes/Additions

Manual Updates

ICD-10 CMS-1500 Provider Manual (Effective 10.1.15)

ICD-9 CMS-1500 Provider Manual (Prior to 10.1.15)

2/4/15 Provider Manual Quarterly Updates

9/30/15 Entire manual has been updated, including ICD10 changes

7/1/15 Updated CMHW Chapter 10.8

3/13/15  Updated CLIA Tables in Chapter 10, updated HPV Section

2/19/15  Updated Retention of Records Section 3.8.2, updated Chapter 9 Wyoming HIPAA 5010 Electronic Specifications, updated Benefit Plan Guide

1/28/15 V4  Upated Benefit Plan Guide Appendix

1/26/15 V3  Updated Community Mental Health Center and Susstance Abuse Treatment Center Tables, updated Speech Therapy Billing Code Table to include Code 92610, updated Invoice Charges Section  6.7.1

1/17/15  V2 Added Cod 64570 to Vagus Nerve Stimulation code range

1//1/15  V1  Last Manual from 2014

PCP Attestation Information/Form




CMS 1500 Provider Bulletins

2016 Provider Bulletins

External Cause Codes
Cap Limit Changes
DMEPOS Face to Face Visit Requirements
Ambulance Trip Report WATRS
Medicare Cross Over Policy
Wyoming Medicaid Budget Cuts
Policy Updates Regarding Presumptive Eligibility and Benign Lesions
Wyoming Medicaid Critical Contact Information Policy Update
Dietitian Covered Services
Documentation Standards
Additional Budget Cut Details
Wyoming Medicaid Budget Reduction Plan
Access Review Monitoring Plan
Immunization Conference Presentation 5.11.16
Ordering, Referring, Prescribing Provider Claims Requirements
1st Qtr 2016 Health Check Newsletter
Wyoming Medicaid Genetic Testing PA Requirements 2.29.16

2015 Provider Bulletins

Provider Manual Quarterly Updates 12.4.15
Therapy Services Policy Update
Final Re-Enrollment Reminder Notice
External Cause Codes 10.16.15
Chiropractic Services Notification 9.23.15
ICD-10 Important Facts and Dates
ICD-10 Implementation
URGENT: Electronic Claim Submission Mandate 6.2.15
Important Medicaid Policy Changes 6.1.15
PERM Provider Education 5.18.15
Provider Workshops - Summer 2015
Electronic Billing Mandate 4.2.15
Re-Enrollment Deadline Approaching 4.1.15
Phototherapy Services 2.20.15
Emergency Indicator 1.1.15



Additional Links

Medicaid and State Healthcare Benefit Plans: Provides client benefit plan names, descriptions, eligibility limitations, coverage types and coverage limitations. This information is useful when determining if a client is eligible for services.

NDC Crosswalk : Provides a listing of the drug related procedure codes requiring an NDC. The listing provides the NDC, HCPCS (J codes), HCPCS and NDC descriptions, effective dates, end dates, and if applicable for Medicare crossovers only.

Carrier Code List: List of Insurance Carrier Codes and Names