esMD for Review Contractors

The Electronic Submission of Medical Documentation (esMD) system allows Medicare providers and suppliers to exchange medical documentation and responses with Medicare review contractors (RCs). esMD enables the electronic submission of information, replacing paper documents where possible and reducing the burden on providers and suppliers.

If you are a review contractor interested in accepting or requesting documents electronically through esMD:

1. Review the Introducing esMD to New Providers, Review Contractors, and Health Information Handlers (PDF) for details on requests and responses supported by esMD.
2. Complete the following:
   1. Submit the esMD RC Onboarding Request Form (PDF).
   2. Follow the IDM Instructions.
   3. Follow the esMD Steps for Onboarding an RC to esMD (PDF).

Once the required credentials are approved and the infrastructure related activities are complete, the RC Client needs to be installed after reviewing the RC Client Java User Guide and Installation Handbook (PDF) or the RC Client Microsoft .NET User Guide and Installation Handbook (PDF).

Contact the esMD Help Desk for additional assistance.

Current Release Documents

Release specific documents that are sent via notification by the esMD Help Desk will also be published on the website. The esMD technical team distributes the following documents during the course of the release:

Current Release Information (May 2024 Off-Cycle Release)

• Release Summary Document (Notification 1070, sent 3/15/2024) (PDF)
• RC Preliminary Technical Release Change Document
• RC Final Technical Release Change Document

Note : This section will have documents for the upcoming release. After the updates are available, all documents related to that release will be removed as all the details will become part of the RC Implementation guide for .NET (PDF) or JAVA (PDF).

Frequently Asked Questions

How can an RC request access to the esMD Application using the CMS Enterprise Portal System (EPS)?

Please refer to the document esMD Role Request Quick Reference Guide (PDF) for more information.

Where can I find the esMD RC Implementation Guide and the Prior Authorization (PA) Reason Codes and Statements?

Please check the below mentioned website sections/links periodically for the latest versions of the:

• esMD RC Implementation Guides

  • RC Client Java User Guide and Installation Handbook (PDF)
  • RC Client Microsoft .NET User Guide and Installation Handbook (PDF)
• Review Reason Codes and Statements (PDF)

What are the PA reject codes used to reject a PA request?

Please use the codes mentioned in the extensive list: Prior Authorization Reject Codes (PDF).

How can RCs contact HIHs for additional information?

Please refer to the document HIH POC for RC Use (PDF) that has the list of points of contact for the HIHs.

Can you provide a list of error codes that are used by esMD to reject RC transactions?

Error Codes From esMD to RCs (PDF) has the current list of error codes.

What is Medicare Fee-for-Service program?

Visit Medicare Fee-for-Service Compliance Programs for more information.