AMA Clinical Examples in Radiology - 2010 Bulletin 1
Medicare Requires Referring Physicians to Be Enrolled in PECOS by 2011
Medicare Requires Referring Physicians to Be Enrolled in PECOS by 2011 The Centers for Medicare and Medicaid Services (CMS) announced a further delay in requiring that ordering and referring physicians be enrolled in Medicare's Provider Enrollment Chain and Ownership System (PECOS). A large percentage of ordering and referring providers are still not aware of this enrollment requirement and have not complied; therefore, the April 5, 2010, implementation date was extended until January 3, 2011. As of January 3, 2011, Medicare claims will be marked for nonpayment when physicians and other health care practitioners ordering services are not enrolled in...
Subscribe or sign in to view the full article.
Article Overview
This article covers a CMS update about Medicare enrollment requirements for ordering and referring physicians and other practitioners, including the delayed implementation timeline and the practical impact on claim payment. It is relevant to radiology and other specialties that rely on ordered services, and it summarizes CMS resources for checking enrollment status and understanding the policy change.
Why This Topic Matters
The article matters because provider enrollment status can affect whether Medicare pays for ordered services, creating potential reimbursement disruptions for practices and their referring provider networks. It is useful for billing staff, compliance teams, radiology practices, and physicians who need to understand the CMS process and timeline.
What You Will Learn
- The CMS update to Medicare’s ordering and referring provider enrollment requirement
- Why enrollment status in PECOS matters for claims processing
- How the policy change may affect practices that provide ordered services
- Where CMS resources are located for enrollment and provider list checks
Who Should Read This
- Radiologists
- Radiation oncologists
- Billing and coding professionals
- Practice managers
- Compliance staff
- Medicare-enrolled physicians and practitioners
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com
