Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency

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Effective May 1, 2013, physicians who refer or order services for Medicare Part B, DME, and Part A Home Health Agency, will be required to be enrolled in Medicare. Claims submitted on or after May 1st for a physician who referred or ordered services for a Medicare patient but who is not enrolled in Medicare will be denied. This includes Durable Goods and recurring monthly supplies that begin on or after May 1st.

Providers should enroll online through PECOS, the Provider Enrollment, Chain, and Ownership System or they can mail enrollment application CMS-8550. Physicians who have a valid opt-out affidavit on file are not required to enroll in Medicare.

Visit the CMS web site for more information.


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