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Technical Specifications

Companion Guides

Health Care Claim: Professional (837P) Internal PDF file (1 MB) (06/15/2020)

This guide contains information regarding the X12 837 Professional claim format including Medicare specific information and requirements. This is intended to be used in addition to the other X12 837P reference documents.

Health Care Claim: Payment/Advise (835) Internal PDF file (2 MB) (06/15/2020)

This guide contains information regarding the X12 835 Remittance Advice format including Medicare specific information and requirements. This is intended to be used in addition to the other X12 835 reference documents.

Health Care Claim: Request & Response (276/277) Internal PDF file (2 MB) (06/15/2020)

This guide contains information regarding the X12 276/277 Claim Status Request/Response transactions including Medicare specific information and requirements. This is intended to be used in addition to the other X12 276/277 reference documents.

National Council for Prescription Drug Programs (NCPDP) D.0 Companion Guide Internal PDF file (664 KB) (06/15/2020)

This guide contains information regarding the NCPDP D.0 claim format. This is intended to be used as a reference document in addition to the other NCPDP reference documents. This document addresses only Medicare DMEPOS specific information.

Technical Reports Type 3 (TR3) and NCPDP Reference Documents

The TR3s (5010) can be downloaded for a fee at https://www.nex12.org External link 

The NCPDP Reference Documents can be downloaded for a fee at http://www.ncpdp.org External link