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Medicare Enrollment InformationThe Society of Cardiovascular Computed Tomography has developed this informational page to assist members in understanding Medicare provider and supplier enrollment.BackgroundThe Centers for Medicare & Medicaid Services (CMS) requires physicians and non-physician practitioners to enroll and maintain Medicare program enrollment to be eligible to receive Medicare payments for covered services furnished under Medicare. CMS has established Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for physicians, non-physician practitioners and providers and suppliers organizations.IssueAll Medicare providers must also be enrolled in PECOS. Physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 must update their enrollment record now. This will establish a current enrollment record in PECOS.After January 3, 2011, all tests or medical equipment ordered by physicians not enrolled in PECOS will be automatically rejected for payment by Medicare, regardless of the indication for the test. Thus if you perform an CCTA or any other test ordered by a "non-PECOS-enrolled" provider, that test will NOT be reimbursed. Medicare non-participating and opt-out physicians also need to be enrolled in PECOS or any tests they order will not be reimbursed. What Can You DoIf you are already enrolled in Medicare, make sure you have a current PECOS enrollment record.CMS has made available a file that contains the National Provider Identifier (NPI) and the name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS that contain an NPI). This file is downloadable from the Medicare provider/supplier enrollment web site: www.cms.hhs.gov/MedicareProviderSupEnroll click on "Ordering/Referring Report" on the left-hand side. Encourage physicians who refer to you and your practice to verify their PECOS status. Additional information about Internet-based PECOS and a link to Internet-based PECOS may be found on the Medicare provider/supplier enrollment website at www.cms.hhs.gov/MedicareProviderSupEnroll. UPDATE: CMS Delays PECOS Deadline to January 3, 2011. Click here for more information. IMPORTANT UPDATE ON CMS PECOS ENROLLMENT DEADLINE — More Information |
