Medicare Rolls Out Temporary Provider Enrollment Flexibilities During COVID-19 Emergency

March 26, 2020

During the COVID-19 Public Health Emergency (PHE), CMS is exercising its authority under Section 1135 of the Social Security Act to allow physicians and non-physician practitioners to temporarily enroll as Medicare providers using a toll free hotline.  MACs are expected to be able to complete the abbreviated process over the phone and completed enrollments are expected to be effective as early as March 1, 2020.

To initiate temporary billing privileges, providers will be asked to provide limited information including, but not limited to, Legal Name, Address, NPI, SSN, a valid license and phone number.

During this temporary period, CMS will waive the following screening requirements:
•    Criminal background checks associated with fingerprint-based criminal background checks (to the extent possible)
•    Site visits
•    Postpone all revalidation actions

According to the related FAQ Document, once the PHE declaration has been lifted providers will be asked to submit a complete CMS-855 enrollment application in order to establish full Medicare billing privileges.  Failure to respond to the MAC’s request within 30 days of the notification will result in the deactivation of the temporary billing privileges.  

This expedited process does not impact enrollment applications submitted prior to March 1st through the regular enrollment process.

The revalidation process, which is currently temporarily suspended, will be resumed with its normal activities once the PHE has been lifted.

The FAQ Document containing additional information and the toll-free numbers for the individual MACs can be found at:

https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf