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Federal Regulations


Medicare State Operations Manual (SOM)

To access the appendixes please go to the SOM Table of Contents. Each Appendix is a separate file that can be accessed directly from the SOM Table of Contents.  Select the corresponding letter through the link above.

Table of Contents

​A ​Hospitals
​AA ​Psychiatric Hospitals
​B ​Home Health Agencies
​C ​Laboratories and Laboratory Services
​D ​Portable X-Ray Service
​E ​Outpatient Physical Therapy or Speech Pathology Services-Interpretive Guidelines
​F ​Physical Therapists in Independent Practice - Deleted
​G ​Rural Health Clinics (RHCs)
​H ​End-Stage Renal Disease Facilities
​I ​Life Safety Code
​J ​Intermediate Care Facilities for Persons With Mental Retardation
​K ​Comprehensive Outpatient Rehabilitation Facilities
​L ​Ambulatory Surgical Services Interpretive Guidelines and Survey Procedures
​M ​Hospice
​N ​Pharmaceutical Service Requirements in Long- Term Care Facilities - Deleted
​P ​Survey Protocol for Long-Term Care Facilities
​PP ​Interpretive Guidelines for Long-Term Care Facilities
​Q ​Determining Immediate Jeopardy
​R ​Resident Assessment Instrument for Long-Term Care Facilities
​S ​Mammography Suppliers – Deleted
​T ​Swing-Beds
​U ​Responsibilities of Medicare Participating Religious Nonmedical healthcare Institutions
​V ​Responsibilities of Medicare Participating Hospitals In Emergency Cases
​W ​Critical Access Hospitals (CAHs)
​Y ​Organ Procurement organizations (OPO)
​Z ​Emergency Preparedness for All Provider & Certified Supplier Types

Horizontal rule (ornamental) 

Federal Fire & Life Safety Regulations

Life Safety Code regulations have recently been adopted from NFPA 101 Life Safety Code (2012) and NFPA 99 Health Care Facilities Code (2012). You can access the new regulations in the CMS-2786R (Health Care Facilities except ASCs) or the CMS-2786U (Ambulatory Surgical Centers-ASCs & End-Stage Renal Disease Facilities-ESRDs).  These documents provide the regulatory reference, in addition to the associated K-Tag. Furthermore, crosswalks have been developed to aide in the transition from LSC 2000 to LSC 2012. A crosswalk compares changes from the 2000 edition of the NFPA documents to the 2012 edition.
Horizontal rule (ornamental) 
CMS Manuals, Program Transmittals
  • To find Transmittals — Click on CMS Transmittals
  • To find State Operations Manual --Click on Internet-Only Manuals (IOMs) on the left navigation bar
  • Scroll down to and Click on the link to 100-7
  • Click appendices for individual provider regulations and Interpretative Guidelines
CMS Program Letters (Memos)
  • Click Policy and Memos to States and Regions on the left Navigation bar
  • You can scroll down the list by Memo Number and Date, and then Click on the link for the specific policy or letter.
Center for Medicare and Medicaid Services (CMS)
  • US Government Centers for Medicare and Medicaid Services (CMS)
  • Policy & Memos to States and Regions from CMS
  • Program Letters
Please Note: It is recommended that providers check the CMS Web Site Addresses weekly for new program letters, for information regarding the State Operations Manual updates, and for new updates on the MDS and OASIS web sites.