Medicare Corner: PTAN Numbers for All!

Do you bill Medicare? Do you have multiple locations or are looking to open another location? If you answered yes to these questions, this article is for you!

We’ve seen an influx in requests from the National Supplier Clearinghouse (NSC) asking that we reach out to facilities that are using the same Provider Transaction Access Number (PTAN) for multiple locations. Each physical facility location must have its own PTAN (or Medicare Identification) number even if multiple locations are within the same organization.  

Facilities should verify that they have separate numbers for each location. If you find that your facilities are using the same PTAN, you will need to submit the CMS 855S form to the NSC to get numbers for those locations. You must update the PTAN number on your ABC record by emailing us at accreditation@abcop.org.

References:

DMEPOS Supplier Standards
42 CFR § 424.57 - Special payment rules for items furnished by DMEPOS suppliers and issuance of DMEPOS supplier billing privileges:

(b) General rule. A DMEPOS supplier must meet the following conditions in order to be eligible to receive payment for a Medicare-covered item:

(1) The supplier has submitted a completed application to CMS to furnish Medicare-covered items including required enrollment forms. (The supplier must enroll separate physical locations it uses to furnish Medicare-covered DMEPOS, with the exception of locations that it uses solely as warehouses or repair facilities.)

(2) The item was furnished on or after the date CMS issued to the supplier a DMEPOS supplier number conveying billing privileges. (CMS issues only one supplier number for each location.) This requirement does not apply to items furnished incident to a physician's service.

Program Integrity Manual (PIM)
Chapter 10 (Provider Enrollment) / Section 10.6.5(D) Medicare Organization Providers and Subparts / DMEPOS Suppliers

Each practice location of a supplier of DMEPOS must, by law, be separately enrolled in Medicare and have its own unique Medicare identification number. 

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