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  • Qualified Medical Beneficiary Indicator
  • Post author
    Lacy Gaskins

Qualified Medical Beneficiary Indicator

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) utilize an indicator of Qualified Medicare Beneficiary (QMB) status to the Medicare Fee-For-Service claims processing systems. The QMB program assists low-income Medicare beneficiaries, who, by federal law, pay no Medicare deductibles, copays, or coinsurance. CMS instructs MACs to create a new beneficiary auxiliary file with dual status codes and a QMB indicator.

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R1786OTN.pdf

Subject: Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System

Number: 3715

Title: Change Request 9911

Release Date: Feb. 3, 2017

Effective Date: April 21, 2016

Implementation Date: July 3, 2017

Special Notes: N/A

  • Post author
    Lacy Gaskins

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