Federal programs
CMS manuals, Medicare coverage sources, federal Medicaid materials and official enrollment guidance.
POLICY SOURCE LIBRARY
Start with the official rule source.
Use these source groups to locate the policy, manual, provider bulletin or enrollment rule that may apply to a payer finding. The exact plan, state, network, service date and policy version still have to be matched to each claim.
WHAT IS COVERED
National, state and payer source starting points
The library is organized for broad market research. A listed payer or program is not a statement that every plan document or historical version has been verified.
State Medicaid programs
Official program sites, provider manuals and bulletins for all states and the District of Columbia.
Major payer families
National and large regional payer policy portals selected to represent at least 95% of nationwide covered lives when combined with public programs.
FOR PROVIDERS
What this means in plain English
A policy helps explain what the payer says was required. It does not prove that the rule applied to your exact claim or that the payer’s finding was correct.
- Match the rule to the service date.
- Confirm the plan, state and network.
- Keep the exact version and source link.
- Compare the rule with the record actually sent to the payer.
VERIFICATION STANDARD
Every useful policy citation needs context
Policy materials are provided for research and document organization. They are not legal advice, a coverage guarantee or a prediction of how a payer, regulator or court will decide.