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Medicare Administrative Contractors

Medicare Administrative Contractors

A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries. CMS relies on a network of MACs to serve as the primary operational contact between the Medicare FFS program and the health care providers enrolled in the program.

Implementation of the Medicare Administrative Contractors (MAC)

As of 2014, there are 12 contractors, sectioned by jurisdiction, responsible for processing Part A and B claims, and there are 4 contractors responsible for Durable Medical Equipment (DME). Of the A/B MAC contractors, four of these MACs are responsible for handling Home Health and Hospice (HH+H) claims, in addition to their typical Part A and Part B claims.

A map illustrating the current Medicare Administrative Contrator (MAC) Jurisdictions can be found here: A/B MAC Jurisdictions Maps

The most recent list of contractors, including jurisdictions and responsibilities, can be found here: Medicare Administrative Contractors (MACs)

CMS maintains web pages for each of the contractors, which can be accessed by clicking your jurisdiction’s corresponding link under A/B MACs and HH+H Areas

Carrier Advisory Committee (CAC)

The CAC acts as a formal mechanism for physicians in the state to be informed about and to participate in the development of Local Coverage Determinations (LCD) in an advisory capacity, a mechanism to discuss and improve administrative policies that are within carrier discretion and a forum for information exchange between carriers and physicians.  

To obtain contact information for your CAC, contact Health Policy.