Important Medicare Date for Referring/Ordering Physicians

Medicare is preparing to go live on May 1 with the referring/ordering edits that will result in claims denials unless the referring/ordering physician or other health care provider is not enrolled in Medicare (or has a valid opt-out affidavit on file with their local Medicare contractor). To be clear, it is the billing providerís claim that is at risk of being denied.

The American Medical Association (AMA) and MGMA have prepared a fact sheet to address which services are impacted, opted-out physicians, as well as frequently asked questions. Click to download the AMA Fact Sheet. For more information on Medicaid enrollment, visit the AMA website.

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