Centers for Medicare & Medicaid Services (CMS) Regulations and Guidelines

Code of Federal Regulations (CFR)

The Code of Federal Regulations (CFR) is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government. It is divided into 50 titles that represent broad areas subject to Federal regulation. Each title is divided into chapters, which usually bear the name of the issuing agency. The title that pertains to Administrative Law Judge (ALJ) hearings is Title 42: Public Health; part 405.

Where is it?
The online version of the CFR is the most updated version. The address is: http://ecfr.gpoaccess.gov .

How can it be utilized?
Noridian utilizes the CFR for procedural questions regarding ALJ hearings. Once open to Title 42 CFR 405 on the website, various searches can take place regarding the rules pertaining to and revolving around an ALJ hearing.

Internet-Only Manual (IOM)

The Internet-only Manuals (IOMs) are a replica of the Agency's official record copy. They are CMS' program issuances, day-to-day operating instructions, policies, and procedures that are based on statutes, regulations, guidelines, models, and directives.

Where is it?
The online manuals are found on Centers for Medicare & Medicaid Services (CMS) website: http://www.cms.gov/Manuals/IOM/list.asp

How can it be utilized?
The IOM’s are used to define what services are covered under Medicare.

Which sections do we reference?

• IOM 100-2 , Chapter 15, Section 110 – The definition of Durable Medical Equipment (DME) and what the classifications of DME are.
• Section 120 – Prosthetic Devices
• Section 130 – Leg, Arm, Back and Neck Braces, Trusses, and Artificial Legs, Arms, and Eyes
• Section 140 – Therapeutic Shoes