Which DME MAC handles your claim: Jurisdictions A, B, C, and D

Citations verified against the CMS Medicare Coverage Database · Reviewed September 2026

A DME MAC — Durable Medical Equipment Medicare Administrative Contractor — is the private contractor that processes Medicare DMEPOS claims, prior authorization requests, and medical review for a defined group of states. There are four jurisdictions. Noridian Healthcare Solutions holds Jurisdictions A and D; CGS Administrators holds Jurisdictions B and C.

This guide lists the states in each jurisdiction, explains why routing follows the beneficiary rather than the supplier, and points to where each MAC's portal and prior authorization contacts are published.

How this gets reviewed: Jurisdiction follows the beneficiary's permanent address, not the supplier's location. A supplier in Ohio serving a patient who lives in Pennsylvania submits to Noridian Jurisdiction A, not CGS Jurisdiction B. Misrouted requests are a real problem: Noridian notes it frequently receives responses meant for other contractors, and every misroute costs days.

The requirements, with citations

The elements below are drawn from the cited CMS and DME MAC sources, not from AffirmDME's rules engine.

Required

Jurisdiction A — Noridian Healthcare Solutions

Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Noridian has held the Jurisdiction A contract since July 2016 and was re-awarded it in 2025.

CMS — Who are the MACs: DME MAC Jurisdiction A

Required

Jurisdiction B — CGS Administrators

Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin. Seven states, roughly 18% of the national DME workload by CMS's count.

CMS — Who are the MACs: DME MAC Jurisdiction B

Required

Jurisdiction C — CGS Administrators

Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia. Jurisdiction C is the largest of the four by geography.

CMS — Who are the MACs: DME MAC Jurisdiction C

Required

Jurisdiction D — Noridian Healthcare Solutions

Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming.

CMS — Who are the MACs: DME MAC Jurisdiction D

Required

Route by the beneficiary's permanent address

Noridian's prior authorization instructions say documentation must be submitted to the jurisdiction based on the beneficiary's permanent address, and CMS's operational guide lists PA contacts as “for beneficiaries residing in Jurisdiction A states,” and so on. The supplier's own state is irrelevant to routing.

Noridian — Prior Authorization for Power Mobility Devices

Required

Portals and PA contacts: Noridian Medicare Portal and myCGS

Noridian suppliers use the Noridian Medicare Portal (NMP) for Jurisdictions A and D; CGS suppliers use myCGS for Jurisdictions B and C. Each jurisdiction's prior authorization fax number, mailing address, and phone line are listed in Section 4.1.1 of CMS's DMEPOS PA Operational Guide and on each MAC's prior authorization pages.

CMS DMEPOS PA Operational Guide §4.1.1

What usually sinks these claims

The PAR goes to the supplier's home jurisdiction instead of the one covering the beneficiary's permanent address
The same coversheet is faxed to both Noridian and CGS as insurance — duplicate submissions slow processing rather than speed it
The beneficiary has moved and the address on the Medicare record no longer matches the delivery address, so the request lands with the old jurisdiction
A multi-state supplier tracks its affirmation rate as one number when the MACs assess it per jurisdiction and PTAN

One workspace for both MACs

AffirmDME scopes each case's readiness checklist to the beneficiary's jurisdiction and tracks affirmation rates by location and PTAN. Try it on a sample case in the free sandbox.

Start in the sandbox

FAQ

Is the DME MAC the same as my Part B MAC?

No. CMS contracts DME MACs specifically to process DMEPOS claims for a jurisdiction; Part A and Part B claims run through separate A/B MACs with their own jurisdictions. A DME supplier deals with Noridian or CGS regardless of which A/B MAC serves the ordering practitioner.

Which MAC do I use if the patient spends winters in another state?

The one covering the beneficiary's permanent address as recorded with Medicare. A seasonal address does not change jurisdiction. If the patient has genuinely relocated, the Medicare record needs to reflect that before the jurisdiction changes.

Where do I find the PA fax number and mailing address?

Section 4.1.1 of the CMS DMEPOS PA Operational Guide lists the phone, fax, mail, and esMD details for all four jurisdictions, and each MAC repeats them on its prior authorization pages. Portal submissions through NMP or myCGS need no coversheet.

Does AffirmDME know which MAC a case belongs to?

AffirmDME scopes each case's readiness checklist to its jurisdiction and MAC, and tracks affirmation rates by location and PTAN — the same split the MACs use for the exemption assessment.

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This guide summarizes Medicare requirements as implemented in AffirmDME's compliance engine, with citations to the governing sources. It is not legal or billing advice; LCDs and CMS policy change — always confirm against the current policy text linked above.

Also drawn on: CMS — Who are the MACs .

More guides

Unfamiliar term? The glossary defines ADR, SWO, UTN, PTAN and the rest; the PA List lookup checks any HCPCS code.