American Speech-Language-Hearing Association

Medicare Administrative Contractor (MAC) Resources

Medicare Part B Services

Medicare Administrative Contractors (MACs) regionally manage policy and payment related to reimbursement and act as the fiscal intermediary for Medicare. MACs manage provider claims for payment and establish regional policy guidelines, called Local Coverage Determinations (LCDs). THe MACs are the primary resource for audiologists and speech-language pathologists providing and billing for services to Medicare beneficiaries. The table below includes the following information for each of the Medicare Part B MACs:

  • Link to the MAC website for Part B (outpatient) services, by state
  • How to check patient eligibility and therapy dollars towards the Medicare therapy cap
  • Where to access the Medicare Fee Schedule
  • Where to access Part B LCDs

Note: These resources are compiled annually. Providers should refer to their local MAC [PDF] for the most current information.

MAC Contact Information and Links for Part B Resources

MAC

States Covered

Patient Eligibility & Therapy Dollars

Medicare Fee Schedules

Local Coverage Determinations

Cahaba Government Benefit Administrators

AL, GA, TN

By phone at
  • 877-567-7271 (AL, GA, TN)
  • 866-419-9454 (MS)

Cahaba GBA Medicare Part B Fee Schedule Allowances

  • Select a year
  • Select "Physician Fee Schedule State Search"

Local Coverage Determination (LCD) & Articles

CGS Administrators, LLC

KY, OH

Online at

Kentucky Part B Fee Schedules

Ohio Part B Fees

Kentucky Part B Local Coverage Determinations

Ohio Part B Local Coverage Determinations

First Coast Service Options, Inc. FL, Puerto Rico, U.S. Virgin Islands    

By phone at 877-847-4992

Fee Schedules (will be asked to select location and Part A or B)

 LCDs/Medical Policy (will be asked to select location and Part A or B)

National Government Services, Inc.

CT, NY Online at Connex Online Inquiry System Fee Schedule Information

Medical Policy Center

NHIC, Corp. MA, ME, NH, RI, VT Online at Provider Services Portal Fee Schedules and Related Information

Policy Indices

Noridian Administrative Services, LLC

AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY

Online at Endeavor Medicare Physician Fee Schedule (MPFS) LCDs/Coverage/Medical Review
Novitas Solutions, Inc.

AR, CO, DC, DE, LA, MD, MS, NJ, NM, OK, PA, TX, VA*

*Only for the Counties of Arlington and Fairfax and the City of Alexandria. For the rest of VA, see Palmetto GBA.

Online at Professional Provider Telecommunication Network Medicare Part A and B Fee Schedules

Medical Policy Center

Palmetto GBA

Jurisdiction 1: CA, HI, NV

Jurisdiction 11: NC, SC, VA*, WV

*Excludes Counties of Arlington and Fairfax and the City of Alexandria. For these localities, see Novitas Solutions.

Online at Online Provider Services

Part B Fee Schedules:

Part B LCDs and NCDs:

Wisconsin Physician Service (WPS) Insurance Corporation

Jurisdiction 5: IA, KS, MO, NE

Jurisdiction 8: IN, MI

Legacy Part B*: IL, MN, WI

*These states will be transitioned to National Government Services on September 7, 2013.

CMS Secure Net Access Portal online at:

Fees:

Active/Final Policies:

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