Enrollment: PECOS Ordering/Referring Edits Won't Start Until July, CMS Says

Why This Topic Matters

Providers need to know when Medicare contractors will begin enforcing these administrative requirements so they can avoid claim denials and prepare internal workflows, documentation processes, and enrollment checks in advance.

Article Sections

1. PECOS ordering/referring edits delayed

   Explains the CMS timing change affecting Medicare Part B claims processing and contractor edits related to ordering and referring practitioners. The section also notes the provider systems involved and the revised implementation timeframe.

2. CMS also delays hospices' face-to-face requirement

   Summarizes the separate postponement of enforcement for the new face-to-face encounter requirement affecting hospice and home health providers. It also references stakeholder response and contractor communication about implementation timing.

3. Background on the face-to-face encounter requirement

   Provides general background on the regulatory context for the new encounter documentation requirement and the types of documentation CMS expects. The section frames the policy change without detailing coding or billing instructions.

4. Provider response and implementation reminders

   Covers industry reactions and reminders for providers to continue preparing for compliance during the delayed enforcement period. It emphasizes operational readiness and collaboration among affected providers.