Cms Fundamentals Latest Version / Questions And Correct Answers / A Grade Score Solution 2025.

CMS Fundamentals LATEST
VERSION / QUESTIONS AND
CORRECT ANSWERS / A GRADE
SCORE SOLUTION 2025.



1. What is the primary purpose of Medicare?
A) Provide health insurance for all U.S. citizens
B) Provide health insurance primarily for people aged 65 and older and
certain younger people with disabilities
C) Provide health insurance for low-income individuals regardless of age
D) Provide insurance coverage only for veterans
Answer:
B) Provide health insurance primarily for people aged 65 and older and
certain younger people with disabilities
Rationale:
Medicare is a federal health insurance program mainly for people 65
years or older, and also for some younger individuals with disabilities or
specific diseases like End-Stage Renal Disease (ESRD). Medicaid, not
Medicare, primarily serves low-income individuals.

,2. Which of the following is NOT one of the original parts of Medicare?
A) Part A (Hospital Insurance)
B) Part B (Medical Insurance)
C) Part C (Medicare Advantage)
D) Part D (Prescription Drug Coverage)
Answer:
D) Part D (Prescription Drug Coverage)
Rationale:
Parts A and B were part of the original Medicare program when it was
created in 1965. Part C (Medicare Advantage) was introduced later as a
private plan option, and Part D, which covers prescription drugs, was
added in 2006.


3. What is the role of the Centers for Medicare & Medicaid Services
(CMS)?
A) To provide direct health care services to patients
B) To administer Medicare, Medicaid, and other health programs
C) To act as a private insurance company
D) To oversee only state health insurance exchanges
Answer:
B) To administer Medicare, Medicaid, and other health programs
Rationale:
CMS is a federal agency within the Department of Health and Human
Services (HHS) responsible for administering Medicare, Medicaid, the
Children’s Health Insurance Program (CHIP), and implementing health
reform initiatives.

,4. Which of the following services is typically covered under Medicare
Part A?
A) Outpatient physician visits
B) Skilled nursing facility care after hospitalization
C) Prescription drugs
D) Routine dental care
Answer:
B) Skilled nursing facility care after hospitalization
Rationale:
Medicare Part A covers inpatient hospital stays, skilled nursing facility
care (usually after a qualifying hospital stay), hospice care, and some
home health care. Physician visits are typically covered under Part B,
while prescription drugs are covered under Part D.


5. Medicaid eligibility is primarily based on:
A) Age
B) Income and financial need
C) Employment status
D) Veteran status
Answer:
B) Income and financial need
Rationale:
Medicaid is a joint federal and state program that provides health
coverage primarily for low-income individuals and families. Eligibility
varies by state but is largely income-based.

, 6. What is the “two-midnight” rule in Medicare?
A) A rule that determines eligibility for hospice care
B) A guideline for inpatient hospital admission to be covered by
Medicare Part A
C) The time period for submitting Medicare claims
D) A regulation for outpatient observation stays
Answer:
B) A guideline for inpatient hospital admission to be covered by
Medicare Part A
Rationale:
The "two-midnight" rule means that Medicare Part A typically covers
inpatient hospital stays when the doctor expects the patient to require
hospital care that spans at least two midnights. Stays shorter than this
may be considered outpatient or observation services.


7. What type of provider must enroll with CMS to bill Medicare for
services?
A) Only hospitals
B) All health care providers and suppliers who want to receive Medicare
payment
C) Only physicians and specialists
D) Only Medicare Advantage plans
Answer:
B) All health care providers and suppliers who want to receive Medicare
payment
Rationale:
Any provider or supplier who wants to bill Medicare for covered services