Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

The purpose of this Transmittal 11808 Change Request (CR) is to incorporate into Chapter 10 of Pub. 100-08 certain provider enrollment policies included in the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) Final Rule.  The CR is dated January 24, 2023.  The Effective Date is January 1, 2023; unless otherwise specified, the Effective Date is the date of service. The Implementation Date of the CR is January 3, 2023.

The updated Chapter 10 begins on page 7 of this Transmittal.

Please also review the corresponding 3-page MLN Matters Number: MM12865, also dated January 24, 2023.

Affected Providers:

  • Skilled nursing facilities (SNFs)
  • Home health agencies (HHAs)
  • DMEPOS suppliers
  • Medicare Diabetes Prevention Program (MDPP) suppliers
  • Opioid Treatment Program (OTP) providers
  • Other providers billing Medicare Administrative Contractors (MACs) for services they provide to Medicare patients

Make sure your staff know about recent enrollment changes, including:

  • SNF screening and fingerprinting requirements
  • Screening of certain changes of ownership
  • Screening for “bump-ups”