The Centers for Medicare & Medicaid Services (CMS) announced that beginning May 1, 2013, Phase 2 of the Provider Enrollment, Chain, and Ownership System (PECOS) program will begin. Phase 2 requires CMS contractors to deny Durable Medical Equipment, Orthotics, and Supplies (DMEPOS), Part B, and Part A Home Health Agency (HHA) claims if the ordering or referring physician is not enrolled in the PECOS system.
CMS initially delayed implementation of Phase 2 because of the high number of physicians who had not enrolled in PECOS. However, CMS now estimates that less than 1 percent of physicians who order or refer DMEPOS services are not yet enrolled.
CMS has provided the following links to educational material related to Phase 2:
- MLN Matters® article #SE1305 Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME and Part A Home Health Agency (HHA) Claims.
- Medicare Enrollment Guidelines for Ordering/Referring Providers.
- The Basics of Medicare Enrollment for Physicians Who Infrequently Receive Medicare Reimbursement.
