CMS Manual System Department of Health &

Human Services (DHHS)

Pub. 100-07 State Operations Centers for Medicare &
Medicaid Services (CMS)
Provider Certification
Transmittal 205 Date: March 11, 2022

SUBJECT: Revisions to State Operations Manual (SOM), Chapter 2, Section

2779A1 – CCN for Medicare Providers

I. SUMMARY OF CHANGES: Addition of new provider State Codes

NEW/REVISED MATERIAL - EFFECTIVE DATE: March 11, 2022

IMPLEMENTATION DATE: March 11, 2022

The revision date and transmittal number apply to the red italicized material only. Any
other material was previously published and remains unchanged. However, if this
revision contains a table of contents, you will receive the new/revised information only,
and not the entire table of contents.

II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual not updated.)

(R = REVISED, N = NEW, D = DELETED) – (Only One Per Row.)

R/N/D CHAPTER/SECTION/SUBSECTION/TITLE
R 2/2779A1/CCN for Medicare Providers

III. FUNDING: No additional funding will be provided by CMS; contractor

activities are to be carried out within their operating budgets.
Or
Funding for implementation activities will be provided to contractors through the
regular budget process.

IV. ATTACHMENTS:

Business Requirements
X Manual Instruction
Confidential Requirements
One-Time Notification
One-Time Notification -Confidential
Recurring Update Notification

*Unless otherwise specified, the effective date is the date of service.

2779A1 – CCN for Medicare Providers
(Rev.205; Issued: 03-11-22; Effective: 03-11-22; Implementation: 03-11-22)

The CCN for providers and suppliers paid under Medicare Part A have 6 digits. The first
2 digits identify the State in which the provider is located. The last 4 digits identify the
type of facility.

Following is a list of all State Codes:

Alabama 01 New Hampshire 30

Alaska 02 New Jersey 31, 83
Arizona 03, 00 New Mexico 32, 96
Arkansas 04, 89 New York 33, 57
California 05, 55, 75, 92, North Carolina 34, 86
A0, A1, B2
Colorado 06, 91 North Dakota 35
Connecticut 07, 81 Ohio 36, 72, A6
Delaware 08 Oklahoma 37, 90
District of Columbia 09 Oregon 38, 93
Florida 10, 68, 69, A2 Pennsylvania 39, 73, A7
Georgia 11, 85 Puerto Rico 40, 84
Hawaii 12 Rhode Island 41
Idaho 13, 54 South Carolina 42, 87
Illinois 14, 78 South Dakota 43
Indiana 15 Tennessee 44, 88, A8
Iowa 16, 76 Texas 45, 67, 74, 97,
A9
Kansas 17, 70 Utah 46
Kentucky 18, B0 Vermont 47
Louisiana 19, 71, 95, A3 Virgin Islands 48
Maine 20 Virginia 49
Maryland 21, 80 Washington 50, 94
Massachusetts 22, 82 West Virginia 51, 58, B1
Michigan 23, A4 Wisconsin 52
Minnesota 24, 77 Wyoming 53
Mississippi 25, A5 Canada 56
Missouri 26, 79 Mexico 59
Montana 27 American Samoa 64
Nebraska 28 Guam 65
Nevada 29 Commonwealth of the 66
Northern Marianas Islands
Foreign Countries 99
(exceptions: Canada and
Mexico)

New State codes must only be used when all of the existing assigned numbers have been
assigned within each of the CCN ranges available for a facility type.
Assign the last 4 digits, which identify the facility type, sequentially from within the
appropriate CCN range. In a State that has more than one State code and/or a facility type
that has more than one CCN range available, ensure that all the numbers available in one
CCN range have been assigned before implementing the use of a new State code or
numbers in a new CCN range.

For example: You are assigning a CCN to a new Community Mental Health Center
(CMHC) in Florida. Florida has three State Codes: 10, 68 and 69 and three number
ranges for CMHCs: 1400-1499, 4600-4799, and 4900-4999. You have been using State
Code 68 and the CCN range 4900-4999 for CMHC in Florida, and you last assigned 4999
in that State to a CMHC. Given this information, consider the following scenarios:

• Scenario 1. Review the CCN records for Florida to determine if all the numbers in
CCN range 4600-4799 were assigned. It is determined that all those numbers were
previously assigned in Florida. Therefore, look to CMHC CCN range 1400-1499 as
those numbers have not been assigned in Florida; assign 681400 as the CCN for the
new CMHC that is being processed.

• Scenario 2. Review the CCN records for Florida to determine if all the numbers in
CCN range 4600-4799 were previously assigned in Florida. It is determined that
some, but not all, of the numbers in that CCN range were assigned. The last number
in that range that was assigned was 4701. Assign 684702 as the CCN for the new
CMHC that is being processed.

• Scenario 3. Review the CCN records for Florida to determine if all the numbers in
CCN range 4600-4799 were previously assigned in Florida. It is determined that all
the numbers in that range were previously assigned in Florida. It is then determined
after a review of the CCN records that all of the numbers in CCN range 1400-1499
were previously assigned in Florida. Look to see if all three CMHC CCN ranges for
State Code 10 have been assigned. It is determined that all three CCN ranges have
been previously assigned. Then look to State Code 69. You find that no CCN for
CMHC in Florida has been assigned under State Code 69. The new CCN that will be
assigned to the new Florida CMHC will be 691400 because is the first CCN range
under State Code 69 listed for CMHCs. However, if it is determined that one of the
CMHC CCN ranges under State Code 69 has been previously assigned, begin with the
next available number in that CCN range.

NOTE: Once the remaining pool of two digit State numeric codes are exhausted, CMS
will implement a two digit alpha-numeric code system for State Codes. For example:
A0, A1, A2,… B0, B1, B2,…, Z8, and finally Z9). This numbering system will
provide a pool of 260 new State Codes for future use.

Use the following CCN ranges for the facility types indicated:

0001-0879 Short-term (General and Specialty) Hospitals

0880-0899 Reserved for hospitals participating in ORD demonstration project
0900-0999 Multiple Hospital Component in a Medical Complex (Numbers Retired)
1000-1199 Federally Qualified Health Centers (also CCN range 1800-1989)
1200-1224 Alcohol/Drug Hospitals (Numbers Retired)
1225-1299 Medical Assistance Facilities
1300-1399 Critical Access Hospitals
1400-1499 Continuation of Community Mental Health Centers (also CCN ranges
4600-4799 and 4900-4999)
1500-1799 Hospices
1800-1989 Federally Qualified Health Centers (also CCN range 1000-1199)
1990-1999 Religious Non-medical Health Care Institutions (formerly Christian
Science Sanatoria (Hospital Services)
2000-2299 Long-Term Care Hospitals (Excluded from IPPS)
2300-2499 Hospital-based Renal Dialysis Facilities
2500-2899 Independent Renal Dialysis Facilities
2900-2999 Independent Special Purpose Renal Dialysis Facility 1/
3000-3024 Formerly Tuberculosis Hospitals (Numbers Retired)
3025-3099 Rehabilitation Hospitals (Excluded from IPPS)
3100-3199 Home Health Agencies (also CCN ranges 7000-8499 and 9000-9799)
3200-3299 Continuation of Comprehensive Outpatient Rehabilitation Facilities
(also CCN ranges 4500-4599 and 4800-4899)
3300-3399 Children’s Hospitals (Excluded from IPPS)
3400-3499 Continuation of Rural Health Clinics (Provider-based) (also CCN
ranges 3975-3999 and 8500-8899)
3500-3699 Hospital-based Satellite Renal Dialysis Facilities
3700-3799 Hospital-based Special Purpose Renal Dialysis Facility 1/
3800-3974 Rural Health Clinics (Free-standing) (also CCN range 8900-8999)
3975-3999 Rural Health Clinics (Provider-based) (also CCN ranges 3400-3499 and
8500-8899)
4000-4499 Psychiatric Hospitals (Excluded from IPPS)
4500-4599 Comprehensive Outpatient Rehabilitation Facilities (also CCN ranges
3200-3299 and 4800-4899)
4600-4799 Community Mental Health Centers (also CCN ranges 1400-1499 and
4900-4999)
4800-4899 Continuation of Comprehensive Outpatient Rehabilitation Facilities
(also CCN ranges 3200-3299 and 4500-4599)
 4900-4999 Continuation of Community Mental Health Centers (also CCN ranges
1400-1499 and 4600-4799)
5000-6499 Skilled Nursing Facilities
6500-6989 Outpatient Physical Therapy Services
6990-6999 Numbers Reserved (formerly Christian Science Sanatoria (Skilled
Nursing Services)
7000-8499 Continuation of Home Health Agencies (also CCN ranges 3100-3199
and 9000-9799)
8500-8899 Continuation of Rural Health Clinics (Provider-based) (also CCN
ranges 3400-3499 and 3975-3999)
8900-8999 Continuation of Rural Health Clinics (Free-standing) (also CCN range
3800-3974)
9000-9799 Continuation of Home Health Agencies (also CCN ranges 3100-3199
and 7000-8499)
9800-9899 Transplant Centers
9900-9999 Reserved for Future Use
1/ Special Purpose Renal Dialysis Facilities (SPRDFs – these facilities will
be assigned the same CCN whenever they are recertified)

NOTE: Religious Nonmedical Health Care Institutions (RNHCI) are not certified by
SAs. The CCN for RNHCIs are assigned by the Boston CMS RO.

EXCEPTION - Organ procurement organizations (OPOs) are assigned a 6-digit

alphanumeric CCN. The first 2 digits identify the State Code. The third digit is the alpha
character “P.” The remaining 3 digits are the unique facility identifier.

EXCEPTION- As of the cost reporting period beginning on or after October 1, 2019, an

IPPS-excluded hospital is no longer precluded from having an IPPS-excluded psychiatric
and/or rehabilitation unit. See section 2779C and 2779C1 for additional CCN numbering
detail. Note: An IPPS-excluded hospital may not have an IPPS-excluded unit of the same
type (psychiatric or rehabilitation) as the hospital (for example, an Inpatient Rehabilitation
Facility (IRF) may not have an IRF unit).