To receive payment for home health services, any Medicare-enrolled Home Health Agency must file claims containing the name and National Provider Identifier (NPI) of the physician who ordered the service. When billing for an ordered home health service: § The individual physician must be enrolled in Medicare or in an opt-out status. You can verify that the ordering physician is enrolled in Medicare by reviewing the Ordering/Referring Report<http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/MedicareOrderingandReferring.html> on the CMS website. § The NPI used for ordering must be for an individual physician (cannot be a group or organizational NPI). § The individual physician must be of a specialist type that is eligible to order. These individuals include: o Doctors of Medicine or Osteopathy o Doctors of Podiatric Medicine
Failure to meet the requirements mentioned above will result in denied claims once the automatic edits are activated. For additional information, review the Medicare Learning Network's "Medicare Enrollment Guidelines for Ordering/Referring Providers<http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedEnroll_OrderReferProv_FactSheet_ICN906223.pdf>" fact sheet. ________________________________ If you know someone who would like to subscribe to a Medicare Fee-For-Service (FFS) provider listserv, go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads//MailingLists_FactSheet.pdf<http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MailingLists_FactSheet.pdf> . If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/wa.exe?INDEX) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.gov/About-CMS/Agency-Information/ContactCMS/index.html). Thank you.
