Time to Start Using Medicare Beneficiary Identifiers

The Centers for Medicare and Medicaid Services (CMS) have removed social security-based claim numbers from Medicare cards and are instead using Medicare Beneficiary Identifiers (MBIs) for Medicare transactions. All Medicare beneficiaries have received their MBIs, and it is important to collect that information.

Physicians must start using the MBE instead of the social security number for most Medicare transactions including billing, claim status, and eligibility status. This applies to DME transitions just as it does to Part B transactions.

All MBIs are 11 characters long and are made up of only numbers and uppercase letters. Any other character type will not be included in an MBI. You may see dashes between the digits of the MBI. These dashes should not be included when submitting claims.

This change does not impact Medicare Advantage numbers or any Medicare drug plan numbers.

To confirm a Medicare patient’s Medicare Beneficiary Identifier (MBI), use the HIPAA Eligibility Transaction System (HETS) just like the process used with the older numbers.

When?

Now! CMS offered a transition period during which either the old number or the MBI could be used, but that ends December 31, 2019. Regardless of the date of service, after January 1, 2020, the MBI must be used to submit all claims.

Check With Your Vendors and/or Clearing Houses

Even if the MBI is shared with your vendor and/or clearing house, it is wise to check your remittance advice. Only the MBI should appear on the remittance advice. If only the old number or both the MBI and the old number appear on the remittance advice, something is not being done correctly.

References

• Medicare Beneficiary Identifiers (MBIs)
• Centers for Medicare & Medicaid Services New Medicare Card Project Frequently Asked Questions (FAQs)
• September 2019 CGS Medicare Bulletin Jurisdiction 15

DISCLAIMER: The information provided here is intended to educate health care providers regarding compliance for ICD, CPT, and HCPCS coding. The information provided does not guarantee reimbursement and is accurate to the best of our knowledge at the time of this publication. Coding guidelines can change and we encourage you to stay up to date. The existence of a code does not guarantee payment.