Last Modified: 6/6/2018 Location: FL, PR, USVI Business: Part A, Part B
Eligibility verification FAQ
Q: I am a billing provider responsible for furnishing ordered/referred services to Medicare beneficiaries. How can I confirm that an ordering/referring provider is eligible to order and refer items or services for a Medicare beneficiary?
A: A billing provider can verify an ordering/referring provider’s eligibility to order and refer beneficiary services by taking the following steps:
1. Visit the Ordering Referring Report page located on the Centers for Medicare & Medicaid Services’ (CMS’) website.
2. Download the current Medicare Ordering and Referring File, in PDF or CSV format, which will contain the National Provider Identifier (NPI) and the legal name (last name, first name) of any physician or non-physician practitioner eligible to order or refer Medicare beneficiary services and has a current enrollment record in the Provider Enrollment, Chain and Ownership System (PECOS).
Note: Users must have the most recent version of Adobe Acrobat Reader and/or Excel in order to open the files.
Please use your browser's back button to return to the referring page.
Source: CR 6417
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