Medical Billing Services

Medicare Provider Enrollment Flexibilities during COVID-19

CMS is using its authority under section 1135 of the Social Security Act to offer flexibility with Medicare provider enrollment to support the COVID-19 pandemic national emergency.

During the PHE, CMS is allowing physicians and non-physician practitioners to temporarily enroll as Medicare providers using a toll-free hotline provided by their MAC. The numbers are listed at the end of this article.

Physicians and Non-Physician Practitioners Eligible to Enroll in Medicare

  • Establish toll-free hotlines to enroll and receive temporary Medicare billing privileges
    • Waive the following screening requirements:
    • Criminal background checks associated with fingerprint-based criminal background checks (FCBC) – 42 C.F.R 424.518 (to the extent applicable)
    • Site visits – 42 C.F.R 424.517
  • Postpone all revalidation actions

All Other Providers and Suppliers (including DMEPOS) Eligible to Enroll in Medicare

  • Expedite any pending or new applications
    • All clean web applications will be processed within 7 business days and all clean paper applications in 14 business days
  • Waive the following screening requirements for all enrollment applications received on or after March 1, 2020:
    • Application Fee – 42 C.F.R. 424.514
    • Criminal background checks associated with fingerprint-based criminal background checks (FCBC) – 42 C.F.R. 424.518 (to the extent applicable)
    • Site-visits – 42 C.F.R. 424.517
  • Postpone all revalidation actions

What information you should have available to enroll as a physician or non-physician practitioner?

To avail this temporary billing privileges, you will be asked to share limited information about your practice.

  • Legal Name
  • Contact information
  • Address information
  • National Provider Identifier (NPI)
  • Social Security Number
  • A valid in-state or out-of-state license

State Licensure for Medicare Providers

CMS will also provide individual waivers from the Medicare requirement that a physician or non-physician practitioner must be licensed in the State in which they are practicing. Four criteria must be met for the waiver:

  • The physician or non-physician practitioner must be enrolled as such in the Medicare program,
  • The physician or non-physician practitioner must possess a valid license to practice in the State which relates to his or her Medicare enrollment,
  • The physician or non-physician practitioner is furnishing services – whether in person or via telehealth – in a State in which the emergency is occurring in order to contribute to relief efforts in his or her professional capacity, and
  • The physician or non-physician practitioner is not affirmatively excluded from practice in the State or any other State that is part of the 1135 emergency area.

Revalidation Activities are on Hold

  • CMS is temporarily ceasing revalidation efforts for all Medicare providers or suppliers. Upon the lifting of the public health emergency, CMS will resume revalidation activities.

CMS published Provider Enrollment Relief FAQs

Medicare Provider Enrollment Hotline numbers and hours of operation

How to use Medicare Enrollment Hotline?

CMS has established toll-free number hotlines at each of the Medicare Administrative Contractors to enable physicians, non-physician practitioners, and Part A certified providers and suppliers establishing isolation facilities to start temporary Medicare billing privileges.

If due to this pandemic change in practice location then physicians and non-physician practitioners can also contact the hotline to update their location. Physicians and non-physician practitioners can use this hotline to ask questions regarding the other provider enrollment flexibilities afforded by the 1135 waiver.

Providers and suppliers should only contact the hotline for the MAC that services their geographic area. To locate your designated MAC refers to MACs by State.

The hotlines are operational Monday – Friday and at the specified times below:

CGS Administrators, LLC (CGS)

The toll-free Hotline Telephone Number: 1-855-769-9920

Hours of Operation: 7:00 am – 4:00 pm CT

First Coast Service Options Inc. (FCSO)

The toll-free Hotline Telephone Number: 1-855-247-8428

Hours of Operation: 8:30 AM – 4:00 PM EST

National Supplier Clearinghouse (NSC)

The toll-free Hotline Telephone Number: 1-866-238-9652

Hours of Operation: 9:00 AM – 5:00 PM ET

Novitas Solutions, Inc.

The toll-free Hotline Telephone Number: 1-855-247-8428

Hours of Operation: 8:30 AM – 4:00 PM EST

Noridian Healthcare Solutions

The toll-free Hotline Telephone Number: 1-866-575-4067

Hours of Operation: 8:00 am – 6:00 pm CT

Palmetto GBA

The toll-free Hotline Telephone Number: 1-833-820-6138

Hours of Operation: 8:30 am – 5:00 pm ET

Wisconsin Physician Services (WPS)

The toll-free Hotline Telephone Number: 1-844-209-2567

Hours of Operation: 7:00 am – 4:00 pm CT

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