LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone: 305.436.5030
Fax: 305.436.0086
E-mail Address: info {at] LEEDerGroup [dot] com

2013-12 Dear Physician Letter - PECOS Enrollment





NHIC, Corp.
DME MAC A ListServe For Immediate Release

December 12, 2013

Dear Physician Letter – PECOS Enrollment

Dear Physician:

The Centers for Medicare and Medicaid Services (CMS) is expanding claim edits for ordering/referring providers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS). Effective January 6, 2014, implementation of specific edits will occur that will restrict DMEPOS suppliers from receiving payment from Medicare for items that you have prescribed if you do not have a current enrollment in the Medicare Provider Enrollment, Chain and Ownership System (PECOS). Help your DMEPOS supplier to continue providing quality services to your Medicare patients by promptly enrolling in PECOS, or by updating your existing Medicare enrollment information if you have not done so recently.

For any DMEPOS item to qualify for coverage by Medicare it must be ordered by a physician or a practitioner who is eligible to order such item. To be eligible:

Physicians or practitioners must be enrolled in PECOS and
Must be registered in the system and
Have a specialty that is eligible to order DMEPOS items for Medicare beneficiaries.
The provider specialties who can order DMEPOS items include:

Doctor of Medicine or Osteopathy
Doctor of Dental Medicine or Dental Surgery
Doctor of Podiatric Medicine
Physician Assistant
Certified Clinical Nurse Specialist
Nurse Practitioner
Doctor of Optometry
In order to continue to order DMEPOS for Medicare beneficiaries, you will have to enroll in the Medicare program or “revalidate” your Medicare enrollment information. You may do so by:

Using Internet-based PECOS, or
By filling out the appropriate Medicare provider enrollment application(s) and mailing it, along with any required information, to the local Medicare carrier or A/B MAC, who will enter your information into PECOS and process your enrollment application.
To confirm if you have a current enrollment record in Medicare, contact your designated enrollment contractor or you can go on-line, using Internet-based PECOS, to view your enrollment record. While doing so, if you have a PECOS record, ensure that your NPI is in it. If it is not, update your enrollment record.

For additional information consult with your Local A/B Medicare Administrative Contractor.


Paul J. Hughes, M.D.
Medical Director,
DME MAC, Jurisdiction A
NHIC, Corp. Robert D. Hoover, Jr., MD, MPH, FACP
Medical Director,
DME MAC, Jurisdiction C
CGS Administrators, LLC
Stacey V. Brennan, M.D., FAAFP
Medical Director,
DME MAC, Jurisdiction B
National Government Services Eileen M. Moynihan, MD, FACP, FACR
Medical Director,
DME MAC, Jurisdiction D
Noridian Healthcare Solutions