Upcoming Medicare deadline: Physicians who refer or order services must be enrolled by May 1
Starting May 1, physicians who refer or order services for Medicare patients will be required to be enrolled in Medicare. The Centers for Medicare and Medicaid Services announced they will deny claims submitted on or after May 1 that include the name and National Provider Identifier of a physician who referred or ordered services for a Medicare patient but who is not enrolled in Medicare. This requirement was originally scheduled to go into effect in 2010.
Physicians who have opted-out of Medicare and have a current opt-out affidavit on file are not required to enroll in Medicare. CMS also has a separate, shorter enrollment form for physicians and other health professionals who only refer and order services but do not bill Medicare directly, according to the American Medical Association.
Because of technical issues, CMS has delayed the May 1 deadline. We will inform you of the new deadline when they announce it.