Navigating Medicare enrollment for mental health providers (MFTs and MHCs) in 2024 is complex and time-consuming. This webinar provides guidance on eligibility, form types (CMS 855), key terminology, required documentation, fees, PTAN linkage, common errors, and best practices. Proper understanding of application type, NPI type, PECOS requirements, taxonomy designations, and PAR vs. NON-PAR status is crucial to avoid cash flow delays and other systemic issues. With expert guidance, providers can ensure accurate submission and smooth enrollment with Medicare. Understand the CMS 855 enrollment submission process for 2024. Recall CMS 855A, 855B, and 855I Application requirements for 2024. Recall the most complicated sections on the 855 applications for 2024. Recall strategies to complete 855 forms accurately for 2024. Recall ancillary documentation required with 855 enrollment submissions for 2024. Avoid common rejections and errors with 855 form submissions. Recall best practice tips for 855 form submissions for 2024. Register, https://conferencepanel.com/conference/navigating-the-2024-medicare-855-enrolments-form-updates

1. Navigating the 2024
Medicare Enrollment (855)
Updates
PRESENTED BY:
TONI ELHOMS
CCS, CPC, CPMA, CRC, AHIMA-APPROVED ICD-10-CM /
PCS TRAINER
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2. Toni Elhoms, CCS, CRC, CPC, CPMA,
AHIMA Approved ICD-10-CM/PCS
Trainer
❑ CEO – Alpha Coding Experts
❑ Podcast Host – Alpha Coding Podcast
❑ National Speaker - Coding, Compliance, and
Reimbursement SME
❑ Former President of Orlando, FL AAPC Chapter
❑ Expert Witness
❑ Published Author
❑ Consultant/Educator/Trainer
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3. Agenda
What is up with PECOS 2.0?
Discuss the 2024 Medicare Enrollment Updates including
discontinuation of 855R
Review common challenges with form submissions (855-B and I)
Compliance Considerations
Q&A at the end
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4. CMS-855
Form
Types
855 A -
Institutional
providers
855 B -
Clinics/group
practices and
certain other
suppliers
855 I -
Physicians
and non-
physician
practitioners
855 R -
Reassignment
of benefits
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5. Workflow for Enrollment
Gather all provider
contact information
and credentialing
documentation
Login/Register for
NPPES – National
Plan and Provider
Enumeration System
Provider/Practice
NPI – National
Provider Identifier
Number
PECOS - Provider
Enrollment, Chain,
and Ownership
System OR CMS 855
Forms
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6. Methods for Enrollment
• Submit appropriate
paper CMS 855 Form
• Mail supplemental docs
with paper application
CMS 855
Paper
Forms
• Surrogate or Provider
NPPES login
• Include supplemental
docs as attachments
PECOS
online
portal
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7. Important Terminology
❑ Authorized Official – work in PECOS for them and
meet regulatory definition
❑ CEO, CFO, Board Chair, Owner
❑ Access Manager (Formerly Delegated Official) –
manage all business functions and staff-end users,
connections, and surrogates for the organization
❑ Must be approved by Authorized Official
❑ Staff End-User – authorized to make specific
changes/updates on behalf of the organization
❑ Surrogate - authorized to act on behalf of the
organization
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8. Surrogate Program
❑ Enroll in PECOS Identity & Access Management System (I&A)
❑ NPPES
❑ PECOS
❑ Incentive Payments
❑ Requires a paper surrogacy application for CMS to review
❑ Approved – send a request for access to the provider, and the provider must
approve the request
❑ Denied – reapply immediately
❑ Add, modify, and terminate providers from your group login
❑ Comply with access rules for the PECOS Identity & Access (I&A) Management
System
❑ Choose your designation: Authorized/Delegated Official (AO/DO) or Staff End-
User
❑ Manage organizational and individual practitioner enrollments in PECOS
❑ Manage your provider NPI records within the NPPES system
❑ Add, terminate, and authorize staff as PECOS users to streamline workflow
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9. 2024 Medicare Enrollment
Update
❑ CMS will allow MFTs and MHCs to enroll in Medicare and
bill as mental health professionals – greatly expanding
access to BH Providers
❑ 400,000 LMFT and MHCs professionals are now able to
get paid and render services to Medicare Beneficiaries
❑ Goes into effect on January 1, 2024
❑ Requires 2 years of clinical supervised experience to
enroll in Medicare
❑ Make sure NPI Number is linked to the correct Taxonomy
code
❑ Consolidation of 855R and 855I enrollment forms
❑ The National Supplier Clearinghouse (NSC) no longer
processes DMEPOS enrollment applications for Medicare
❑ DMEPOS East and West Contractors now process all
enrollments
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10. Entity Types
Entity Type 1 –
Individual Providers –
Provider’s SSN
Entity Type 2 –
Organizational
Providers – EIN of
entity
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11. Most Common Errors
Missing Signatures
Missing Dates
Signatures must be original and signed in
BLUE INK
E-sign or copied signatures
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12. Most Common Errors
Person signing the form is not a Delegated or
Authorized Party
Wrong CMS 855 Form Type
Providers / Groups don’t terminate their
reassignments
Missing Revalidation Deadline because letter
went to provider’s home
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13. Best Practice Tips
Attention to detail is imperative and staying organized
Have someone else review the application several times over
Include all supporting documentation required
Vet your vendors if outsourcing/proper training if insourcing
Setup Tickler system to remind you of Revalidation Due Dates
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14. Best Practice Tips
Information must be accurate and consistent
Typed Answers and Live Signatures
Respond timely to information requests
Don’t miss revalidation deadlines
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15. Compliance Considerations
❑ Are you using a billing company?
❑ Section 8
❑ Are your NPPs billing incident to your physicians?
❑ All NPPs need to be enrolled
❑ Do you have specialists or multi-specialty?
❑ Specialty designations
❑ Taxonomy linkage between NPPES and CMS
❑ Providers opted out of Medicare or enrolled
solely to order, certify, and prescribe do not
have to revalidate
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16. Navigating
Medicare
PECOS 2.0
Updates
Register
Now
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