Introduction to Medicare data requirements

The Centers for Medicare & Medicaid Services (CMS) requires that Kaiser Permanente, a Medicare Advantage contractor, submit physician, outpatient hospital, and inpatient hospital encounter data.

Medicare members must see a Medicare-certified provider. Many mental health and addiction and recovery practitioners are not Medicare-certified. If a member needs mental health or addiction and recovery services, please contact the Mental Health Access Center for assistance in locating a Medicare-certified provider in your area.

The following apply to all claims for Kaiser Permanente Medicare Advantage plans:

CMS-1500 claims data reporting requirements


NPI and taxonomy requirements

General Medicare data requirements

Medical students providing care

Content on this page is from the provider manual | Disclaimer