Three Reminders to Medicare Providers for Billing Correctly for 
Ordered/Referred Services

Any Medicare-enrolled Part B organizational provider, DMEPOS supplier, or Part 
A Home Health Agency (HHA) provider may file claims with ordering or referring 
information.


1.       There are three basic requirements for ordering and referring:

§  The physician or non-physician practitioner must be enrolled in Medicare or 
in an opt-out status.

§  The National Provider Identifier (NPI) used for ordering/referring must be 
for an individual physician or non-physician practitioner (cannot be an 
organizational NPI).

§  The physician or non-physician practitioner must be of a specialist type 
that is eligible to order and refer.

If you don't meet the three basic requirements listed above, refer to item #3 
below on how to obtain an NPI and enroll in Medicare for ordering and referring 
purposes.


2.       Only Medicare-enrolled individual physicians and non-physician 
providers of a certain specialist type are eligible to order/refer for Part B 
and DMEPOS Medicare beneficiary services.  (Organizational providers cannot 
order and refer.)  Eligible individual physicians and non-physician providers 
include:

§  Doctor of Medicine or Osteopathy

§  Doctor of Dental Medicine

§  Doctor of Dental Surgery

§  Doctor of Podiatric Medicine

§  Doctor of Optometry

§  Doctor of Chiropractic Medicine

§  Physician Assistant

§  Certified Clinical Nurse Specialist

§  Nurse Practitioner

§  Clinical Psychologist

§  Certified Nurse Midwife

§  Clinical Social Worker

Only Medicare-enrolled individual physicians of a certain specialist type are 
eligible to order/refer for Part A when a plan of treatment is needed and 
submitted from an HHA for beneficiary services.  These individuals include:

§  Doctor of Medicine or Osteopathy

§  Doctor of Podiatric Medicine


3.       In order to order/refer, the provider must have an enrollment record 
in PECOS.

§  Providers who order or refer should verify their enrollment in PECOS.  Note 
that receiving payments from Medicare does not necessarily mean you have an 
enrollment record in PECOS.  The easiest way to check on enrollment status is 
by visiting internet-based PECOS at https://pecos.CMS.hhs.gov and navigating to 
the "My Enrollments" page; if no record is displayed, you do not have an 
enrollment record in PECOS.  (More detailed instructions on accessing and 
navigating internet-based PECOS are available 
here<http://www.cms.gov/MedicareProviderSupEnroll/Downloads/Instructionsforviewingpractitionerstatus.pdf>.)
  Another option is to check the Ordering and Referring 
Report<http://www.cms.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp>.

§  If you believe an enrollment application has been submitted but no 
enrollment record exists in PECOS, check the list of pending applications, 
available at 
http://www.CMS.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp
 (scroll to the "Initial Physician Applications Pending Contractor Review" in 
the Downloads section of the page).

§  Providers with neither an enrollment record in PECOS nor an entry on the 
list of pending applications should make arrangements to submit their 
enrollment application.  Internet-based PECOS is the fastest and most efficient 
way to do so.  For instructions, review the Basics of Internet-based PECOS for 
Physicians and Non-Physician 
Practitioners<http://www.cms.gov/MLNProducts/downloads/MedEnroll_PECOS_PhysNonPhys_FactSheet_ICN903764.pdf>.



For additional information, review the Medicare Learning Network's "Medicare 
Enrollment Guidelines for Ordering/Referring Providers" fact sheet at 
http://www.CMS.gov/MLNProducts/downloads/MedEnroll_OrderReferProv_FactSheet_ICN906223.pdf.




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