Learn More
Log In
Sign Up
Requirements for Establishing and Maintaining Medicare Billing Privileges | Midpage
Collections
Code of Federal Regulations
Title 42
Chapter IV
Subchapter B
Part 424
Subpart P
Requirements for Establishing and Maintaining Medicare Billing Privileges
424.500
Scope.
424.502
Definitions.
424.505
Basic enrollment requirement.
424.506
National Provider Identifier (NPI) on all enrollment applications and claims.
424.507
Ordering covered items and services for Medicare beneficiaries.
424.510
Requirements for enrolling in the Medicare program.
424.514
Application fee.
424.515
Requirements for reporting changes and updates to, and the periodic revalidation of Medicare enrollment information.
424.516
Additional provider and supplier requirements for enrolling and maintaining active enrollment status in the Medicare program.
424.517
Onsite review.
424.518
Screening levels for Medicare providers and suppliers.
424.519
Disclosure of affiliations.
424.520
Effective date of Medicare billing privileges.
424.521
Request for payment by certain provider and supplier types.
424.522
Additional effective dates.
424.525
Rejection of a provider's or supplier's application for Medicare enrollment.
424.526
Return of a provider's or supplier's enrollment application.
424.527
Provisional period of enhanced oversight.
424.530
Denial of enrollment in the Medicare program.
424.535
Revocation of enrollment in the Medicare program.
424.540
Deactivation of Medicare billing privileges.
424.541
Stay of enrollment.
424.542
Prohibition on ordering, certifying, referring, or prescribing based on felony conviction.
424.545
Provider and supplier appeal rights.
424.546
Deactivation rebuttals.
424.547
Deactivation based on ordering, certifying, or referring services and items.
424.550
Prohibitions on the sale or transfer of billing privileges.
424.551
DMEPOS supplier changes in majority ownership.
424.555
Payment liability.
424.565
Overpayment.
424.570
Moratoria on newly enrolling Medicare providers and suppliers.
424.575
Rural emergency hospitals.