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CMS-1403-FC
organizations, and individual practitioners or physician
and NPP organizations and individual practitioners that are
establishing or changing a practice location would be
allowed to bill the Medicare program for services furnished
to Medicare beneficiaries on or after the date of filing if
a Medicare contractor approves Medicare billing privileges
and conveys billing privileges to an NPI. It is also
important to note that if a Medicare contractor rejects or
denies an enrollment application, then the physician or NPP
organization or individual practitioner is at risk of not
receiving payment for any services furnished after the date
of filing.
Given this second approach, in proposed §424.520, we
stated that we may implement regulations text that reads
similar to: “the effective date of billing privileges for
physician and NPP organizations and for individual
practitioners, physicians and NPPs, is the later of--(1)
The filing date of the Medicare enrollment application that
was subsequently approved by a FFS contractor; or (2) The
date that the physician or NPP organization or individual
practitioner first furnished services at a new practice
location.”
We also stated in the CY 2009 PFS proposed rule that
we believe that this approach--
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