CMS Releases Enrollment Guidance for Physicians that Infrequently Receive Reimbursement from the Medicare Program

July 20, 2010

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The Centers for Medicare and Medicaid Services (CMS) is now implementing section 6405 of the Affordable Care Act (ACA) by modifying the process of enrollment for physicians who infrequently receive reimbursement from the Medicare program. Physicians will now need to enroll in the Medicare program for the sole purpose of certifying or ordering services for Medicare beneficiaries. The enrollment was specifically modified by CMS to accommodate the particular circumstances of the following individual physicians and practitioners:

  • Physicians employed by:
    • The Department of Veterans Affairs
    • The Public Health Service
    • The Department of Defense Tricare program
    • Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) or Critical Access Hospitals (CAHs)
  • Physicians in a Fellowship
  • Dentists, including oral surgeons

Click here to access the CMS document explaining the modifications to the enrollment process for these special circumstances.