Today, CMS released the list of physician and non-physician practitioners who are enrolled in the Medicare Provider Enrollment, Chain and Ownership System (PECOS). This list includes physicians who are eligible to order and refer DMEPOS items and services because they have a current Medicare enrollment record in PECOS connected with their NPI number.
Beginning October 5 of 2009, CMS began identifying claims submitted by DMEPOS suppliers that did not contain an ordering/referring physician or other health care practitioner enrolled in PECOS. During Phase Two of this new CMS policy, which will start April 5, 2010, all DMEPOS items and services that are billed and that include an ordering/referring physician not enrolled in the PECOS database will be rejected and the claims will not be paid.
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