Who Handles Your Medicare Claims?

What is a Medicare claims office?

Medicare doesn't process claims directly — it hires private companies to do it. The company that handles claims in your state is called a Medicare Administrative Contractor (MAC). These companies are the ones who actually review, process, and pay Medicare claims on behalf of the government.

There are currently 12 claims offices covering different regions across the United States for doctor visits and hospital stays, plus 4 separate offices that handle claims for medical equipment and supplies. Which office handles your claim depends on the state where you received care, not where you live.

Why you need to know your Medicare claims office

When you find an error on a Medicare bill or your Explanation of Benefits (the statement Medicare sends after a claim), your Medicare claims office is the first place to call. Knowing which company handles your claims helps you:

• File appeals faster — Each claims office has its own appeals process and mailing address
• Understand what's covered — Your claims office sets local coverage rules (what Medicare covers in your area), which can vary by region
• Check on a claim — Find out whether a claim was received, processed, or denied
• Report billing problems — Report suspected fraud, duplicate billing, or incorrect charges directly to your claims office
• Learn your area's rules — Coverage rules can differ from state to state, so what Medicare covers in one area might not be covered in another

Two different offices for two types of claims

Your Medicare claims office (Parts A & B) processes claims for doctor visits, hospital stays, and outpatient services. A separate equipment & supplies claims office handles claims for medical equipment and supplies — things like wheelchairs, oxygen equipment, CPAP (breathing machine) machines, and diabetic supplies.

These may be different companies. If you have a billing question about a hospital or doctor visit, contact your Parts A & B claims office. For a question about medical equipment, contact your equipment & supplies claims office.

Why coverage can vary by state

Some coverage rules are national coverage rules that apply everywhere in the country. But each regional claims office can also set its own local coverage rules (what Medicare covers in your area). This means a procedure that Medicare covers in one state might not be covered in another, depending on your claims office's local rules.

If a claim is denied based on a local coverage rule, you have the right to appeal. Knowing your claims office helps you find the specific rule that applies and understand what you need to do.

More free billing tools

BillError provides free tools to help you understand and dispute medical bills:

• Medical Code Lookup — Look up any procedure code to see what it means and what Medicare pays
• Double-Charge Checker — Check if two procedure codes should not be billed together
• Bill Math Checker — Verify the arithmetic on any bill
• Dispute Letter Generator — Create a dispute letter with regulatory citations for any bill type

About this tool

This tool uses official CMS data to find which company handles Medicare claims in each state. CMS periodically changes which companies are assigned to which states. All contact information comes from CMS public data.

Learn more

For a comprehensive guide to understanding and challenging medical bills, read our complete guide to medical billing errors. To learn about your billing rights in your state, see medical bill rights by state.