New Instructions for Suppliers of Implantable Devices

As of October 27, 2008, suppliers of implantable devices can enroll through the National Supplier Clearinghouse as well as the Part B/carrier MAC for Medicare billing privileges. Previously CMS instructed carriers not to enroll manufacturers of implantable or non-implantable prosthetics and DME, or similar organizations/entities into the Medicare program because these manufacturers, organizations or entities that do not qualify as a provider of services or supplier of medical and health services. In lieu of enrollment with the Part B carrier, CMS instructed such suppliers (including manufacturers and similar organizations/entities) that they must enroll with the NSC and bill the Medicare program as a DMEPOS supplier to receive Medicare payment for these items. (See JSM/TDL-06465, issued on May 24, 2006.)

Change Request 5917, reinstates the Part B carrier/MAC jurisdiction for suppliers of replacement parts, accessories and supplies for prosthetic implants and surgically implanted DME only. Suppliers that wish to bill the carrier for these items must enroll with the NSC as a DMEPOS supplier prior to enrolling with, and billing these items to, the Part B carrier/MAC. All suppliers must meet the enrollment standards of the NSC and qualify as a DMEPOS supplier. For more information, view the MLN Matters article posted on the CMS website.

Last Updated: 10/24/2008