Medicare as Secondary Payer

When Medicare is the secondary payer (MSP), you must first submit the claim to the primary insurer. If, after processing the claim, the primary insurer does not pay in full for the services, you can submit the claim to Medicare for consideration of secondary benefits.

Electronic claim submission: To learn how to report MSP claims in your software, contact your software vendor.

Paper claim submission: A paper claim must include a copy of the primary insurer's EOB, which should include the following information: (1) name and address of the primary insurer, (2) name of subscriber and policy number, (3) name of the provider of services, (4) itemized charges for all procedure codes reported, (5) detailed explanation of any denials or payment codes, and (6) date of service.

Learn more about Medicare as secondary payer on the Novitas Solutions website.


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Last Updated On

April 08, 2021

Originally Published On

March 23, 2010