Medicare Administrative Contractors (MAC)

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. The U.S. Centers for Medicare & Medicaid Services (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. MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims.

Which MAC Am I In?

Want to know which MAC jurisdiction you're in? View the A/B MAC Jurisdictions Map as of June 2019. Click here to look up Local Coverage Determinations (LCDs).

The purpose of the MAC Resource Groups (MRGs) is to expedite your need for accurate local Medicare reimbursement information. Our goal is to have information that is MAC-specific flow to programs and for questions/issues from programs to flow up to your state MRG representative to your AACVPR Liaison Task Force member and to the national level when appropriate.

A/B Jurisdiction	AACVPR-MAC Liaison Task Force Member	AACVPR-MAC Resource Group Members	Provider	General Information
J-E (Previously J-1) States: California, Nevada, Hawaii	Lisa Smith (CA) - Pulmonary Julie Rounds (CA) - Cardiac	Missy Von Luehrte (CA) -Pulmonary Julie Kuwada (CA) - Cardiac Alisha Enochs (CA) - Pulmonary Maren Imbriglio (CA) - Cardiac	Noridian	Local Coverage Determination (LCD): Respiratory Care (Respiratory Therapy) (L34149) Revised 10/1/19 Noridian coding requirements for outpatient cardiac rehabilitation services. Revised 10/01/19 Local Coverage Article: Billing and Coding: Respiratory Care (Respiratory Therapy) (A57224) Revised 1/1/20
J-F (Previously J-2 & J-3) States: Alaska Washington Oregon Idaho Montana Wyoming Utah Arizona North Dakota South Dakota	Karen Edwards (ID, OR, WA, AK) Holly Bright (AZ, ND, SD, MT, UT, WY)	Jeff Rhodes (WA) Pat Lara (ID) Ivy Hollinarke (AK) Alexis Miller (OR) Ashley Wendler (SD) Cathy Lisowski (MT) Deborah Brekke (SD) George Heron (UT) Carrie Nix (WY) Dana Gunter (WA) Janelle McCloskey (AZ)	Noridia n	CMS Regulations on Cardiac & Pulmonary Rehabilitation Cardiac and Pulmonary Rehabilitation Medicare Regulations-CMS Policies, Interpretations, Clarifications, & MAC Variations on Common Issues (November 2017)
J-H (Previously J-4 & J-7) States: Colorado New Mexico Texas Oklahoma Arkansas Louisiana Mississippi	Lorri Lee	Christine Alongi (AR) Monica Beeson (Pulmonary Rehab) (OK) Mary (Lynn) Quiram (Cardiac Rehab) (OK) Rhonda Leaverton (Cardiac Rehab) (TX) David Rodriguez (Pulmonary Rehab) (TX) Jarrod Mitchell (LA) Jeanne Carlson (MS) Fairest Stevenson-Matthews (MS)	Novitas	National Coverage Deteremination (NCD) for Cardiac Rehabilitation Programs for Chronic Heart Failure (20,10,1) CMS' ICD-10 Code Look Up Local Coverage Article: Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Physician Requirements (A55758);10-12-17
J-5 States: Nebraska Iowa Kansas Missouri	Susan Flack	Aaron Richardson (IA) Leann Dickson (MO/KS) Debra Dorshorst (MO) Karen Hardy (NE) Buddy Goodenkauf (NE)	WPS	Reimbursement Update J5 & J8 (September 2016) Cardiac and Pulmonary Rehabilitation Medicare Regulations-CMS Policies, Interpretations, Clarifications, & MAC Variations on Common Issues (November 2017)
J-6 States: Minnesota Wisconsin Illinois	Anne Gavic	Rita Szymanski (IL) Paul Spilde (MN) Heather Grant (WI)	NGS	2010 Physician Fee Schedule: Section 410.49-Cardiac Rehabilitation Program: Conditions for Coverage (November 2009) National Coverage Determination (NCD) for Cardiac Rehabilitation Programs for Chronic Heart Failure (20.10.1)
J-8 States: Michigan Indiana	Susan Flack Jacquoline Evans	Susan Bauman (IN) Laura Vaughn (MI)	WPS	Reimbursement Update J5 & J8 (September 2016) Cardiac and Pulmonary Rehabilitation Medicare Regulations-CMS Policies, Interpretations, Clarifications, & MAC Variations on Common Issues (November 2017)
J-N (Previously J-9) State: Florida	Marion Harris-Barter	Shirley Vuille (FL) Ashleigh Funk (FL)	FCSO	Respiratory Therapeutic Services LCD (L28978) (effective 10/1/2011)
J-J (Previously J-10) States: Tennessee Alabama Georgia	Deborah Baker (TN)	Anita Jones (AL) Sheila Kamath (GA) Kathe Briggs (AL) Matt Thomas (TN)	Palmetto	Respiratory Therapy (Respiratory Care) (L34430) Revision Effective Date For services performed on or after 10/24/2019 Local Coverage Article: Billing and Coding: Respiratory Therapy (Respiratory Care) (A56717) Revision Effective Date 10/17/2019 ~~LCD for Cardiac Rehab for L34412. Effective 2/9/19~~ - This LCD has been retired. No active one at this time. Local Coverage Determination (LCD): Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication (L37774); Effective 11/19/2018
J-M (Previously J-11) States: West Virginia Virginia North Carolina South Carolina	Michele Parr	Marianne Sherman (VA) Connie Paladenech (NC) Mark Clair (SC)	Palmetto	Local Coverage Article: Billing and Coding: Respiratory Therapy (Respiratory Care) (A56717) Revision Effective Date 10/17/2019 Respiratory Therapy (Respiratory Care) (L34430) Revision Effective Date For services performed on or after 10/24/2019 ~~LCD for Cardiac Rehab for L34412. Effective 2/9/19~~ - This LCD has been retired. No active one at this time. Local Coverage Determination (LCD): Supervised Exercise Therapy for the Treatment of Peripheral Arterial Disease with Symptomatic Lower Extremity Intermittent Claudication (L37774); Effective 11/19/2018
J-L (Previously J-12) States: Pennsylvania Maryland Washington DC Delaware New Jersey	Ruth Akers	Patricia Comoss (PA, DE, NJ) Stacey Blank (MD) - Pulmonary Terri Pilli (MD) - Cardiac Joan Helfman (NJ) Janice Anderson (DE) Denise Sheffield (PA)	Novitas	National Coverage Determination (NCD) for Cardiac Rehabilitation Programs for Chronic Heart Failure (20.10.1) Local Coverage Article: Cardiac Rehabilitation (CR) and Intensive Cardiac Rehabilitation (ICR) Physician Requirements (A55758);10-12-17 Cardiac and Pulmonary Rehabilitation Medicare Regulations-CMS Policies, Interpretations, Clarifications, & MAC Variations on Common Issues (November 2017)
J-K (Previously J-13 & J-14) States: New York Connecticut Rhode Island Massachusetts Vermont New Hampshire Maine	Murray Low Wayne Reynolds	Mark Cushman (ME) Patrick Savage (VT) Elizabeth Peters (NH) Bryan Briggs (NH) Kate Traynor (MA) Karen Lafond (MA) Karen Pyle (CT, NY)	NGS	As of October, 2013, CMS has merged J-13 & 14 and renamed it J-“K." The Contractor is now NGS. As of January 23, 2014 there have been no policy changes, no LCDs have been adopted and there is currently no indication of impending changes
J-15 States: Ohio Kentucky	Rich Sukeena	Peggy Cox (KY) Stephane Tucker (KY) Katy Maag (OH)	CIGNA	NPP CMS Update - July 2017 CGS Caridac Rehabilitation Update - August 24, 2016 CGS Pulmonary Rehabilitation Update - August 24, 2016 Outpatient Cardiac Rehabilitation with Continuous ECG Monitoring (HCPCS Code 93798): Probe Medical Review -- Kentucky and Ohio; February 1, 2016 CGS-Cardiac Review (2013) Results Greatly Improved - Continued Area of Concern: ITP Documentation (May 24, 2013) Pulmonary Rehabilitation: Coverage and Documentation Requirements Revision (5-29-13) Cardiac Rehabilitation: Coverage and Documentation Requirements (Revision 1-18-13) Cost Accounting Strategy

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