MLN Matters Number: MM6061
Related Change Request (CR) #: 6061
Related CR Release Date: July 18, 2008
Effective Date: October 1, 2008
Related CR Transmittal #: R1550CP
Implementation Date: August 18, 2008
Provider Types Affected
Audiologists submitting claims to Medicare Administrative Contractors (A/B MACs) and carriers for services provided to Medicare beneficiaries.
Impact on Providers
This article is based on Change Request (CR) 6061, which alerts Audiologists who are not currently enrolled that they are required to obtain their NPI and use it on claims for services they render on or after October 1, 2008. An audiologist not previously enrolled with Medicare should initiate Medicare enrollment as soon as they obtain an NPI.
Background
Transmittal 1470, (CR5717) titled, “Update to Audiology Policies”, was issued February 29, 2008, with clarifications to the Medicare Claims Processing Manual. (An MLN Matters article related to CR 5717 is available at www.cms.hhs.gov/MLNMattersArticles/downloads/MM5717.pdf (PDF, 84 KB)). In chapter 12, section 30.3, the manual instructions state, “. . . the audiologist’s NPI is required on all claims for services furnished by audiologists.” CR6061 responds to questions concerning CR 5717.
Key Points
- Audiologists who are enrolled and bill Medicare independently must have obtained their NPI on Medicare claims as of May 23, 2008 and must currently use it on claims for services they render.
- Those audiologists not currently enrolled with Medicare should obtain their NPI and enroll with Medicare as soon as possible prior to October 1, 2008. Audiologists who are not currently enrolled may continue to have their services billed as diagnostic test services by a physician or group until October 1, 2008.
- The audiologist’s NPI is required on all claims for services rendered by audiologists as of October 1, 2008.
Additional Information
To see the official instruction (CR 6061) issued to your Medicare A/B MACs and carriers visit
www.cms.hhs.gov/Transmittals/downloads/R1550CP.pdf (PDF, 142 KB).
To learn more about the NPI and how to obtain your NPI, visit
www.cms.hhs.gov/NationalProvIdentStand/06_implementation.asp. Information on enrolling as a Medicare provider is available at
www.cms.hhs.gov/MedicareProviderSupEnroll/.
If you have questions, please contact our Provider Contact Center at our toll free number at (866) 332-7025 for Ohio and West Virginia or (888) 828-2092 for South Carolina.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.