Medicare Claims Processing Manual (Pub. 100-04), Ch. 30 § 130.1.2
Determining Provider Liability in Claims for Ancillary and
130.1.2 - Determining Provider Liability in Claims for Ancillary and
Outpatient Services
(Rev. 1, 10-01-03)
The procedures in §30.2 apply for determining liability for providers. A provider may
have its liability waived in an individual claim if it can establish that it did not know and
could not have been expected to know that Medicare would not make payment for the
items or services.