Now available: DRAFT Medicare Transaction Facilitator (MTF) 835 Companion Guide – Public Comments Due by Friday, May 30^th 5 PM ET

CMS has posted the Draft MTF 835 Companion Guide and is seeking public comments.  The Draft MTF 835 Companion Guide defines how dispensing entities and their third-party support entities will retrieve claim remittance advice from the MTF and provides technical and connectivity specifications for the 835 Health Care Claim: Payment/Advice transaction Version 005010. This Draft MTF 835 Companion Guide contains instructions for electronic communications as well as supplemental information for ingesting/creating transactions while ensuring compliance with the associated Accreditation Standards Committee X12N Technical Report Type 3 and the Council for Affordable Quality Healthcare – Committee on Operating Rules for Information Exchange (CAQH CORE) companion guide operating rules.  CMS seeks comments on the Draft MTF 835 Companion Guide regarding transaction sets and values the MTF will be transmitting.  Additional file exchange information will be included in a future release.   

Manufacturers are responsible for making Electronic Remittance Advice (for payments issued via electronic funds transfer) or remittance (for payments issued via paper check) available to dispensing entities if a Manufacturer opts out of payment facilitation in the MTF.  Manufacturers are responsible for ensuring that the electronic remittance advice created and transmitted to the dispensing entity uses the X12 835 standard adopted under the Health Insurance Portability and Accountability Act (HIPAA) as applicable.

Public comments on the Draft MTF 835 Companion Guide are due Friday, May 30^th by 5 PM ET.  Please submit comments directly to MFPMedicareTransactionFacilitator@cms.hhs.gov.  CMS anticipates posting a Final MTF 835 Companion Guide in Summer 2025. The Draft MTF 835 Companion Guide is available here.