Practice Management Alerts from the AMA

Practice Management Alerts

May 1: Important Medicare enrollment date  The Centers for Medicare and Medicaid Services (CMS) announced that, starting May 1, physicians who refer or order services for Medicare patients will be required to be enrolled in Medicare. Claims submitted on or after May 1 that include the name and National Provider Identifier (NPI) of a physician who referred or ordered services for a Medicare patient but who is not enrolled in Medicare will be denied. CMS had originally planned to implement this requirement in 2010, but the AMA succeeded in getting it delayed for several years, during which CMS has worked to ensure that physicians are enrolled. Physicians who have a valid opt-out affidavit on file are not required to enroll in Medicare. CMS also has a special, shorter enrollment form for use by physicians and other health professionals who just refer and order services but do not bill Medicare directly, known as the 855-0. More information on the new edits can be found in this CMS article as well as its website. For more information on Medicare enrollment in general, please visit the AMA’s Medicare enrollment website. Was this alert helpful? Forward it to a friend, and invite them to sign up for the AMA Practice Management Alerts to receive future alerts like this one. Be an AMA member. Join the AMA today at ama-assn.org/go/membership or call (800) 262-3211 to be part of the efforts to help shape a better health care future.