Last Modified: 5/14/2020
Location: FL, PR, USVI
Business: Part B
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.
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