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Last Modified: 9/29/2022 Location: FL, PR, USVI Business: Part B

Difference between ‘ordering/referring provider’ and ‘billing provider’ FAQ

Q: What is the difference between an “ordering/referring provider” and a “billing provider”?
A: An ordering/referring provider is the individual who orders or refers an item or service for a Medicare beneficiary (e.g., laboratory diagnostic tests, imaging services, specialty services, durable medical equipment) that will be furnished and billed by another provider or supplier (e.g., laboratory, imaging center, specialist, DME supplier).
The billing provider is the individual or organization that furnishes and bills Medicare for the ordered/referred service provided to the beneficiary.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.