Ordering and Referring Points of Interest

Per MLN SE18008, MACs will process CMS Form-855O provider enrollment applications submitted for unlicensed residents if the application submission includes either:

1. A residency contract signed and dated by both an official of the institution and the resident physician.
2. A letter, on institution letterhead, confirming the applicant’s status as a resident physician signed and dated by an official of the institution and containing at a minimum the name of the applicant.

CMS published CMS-4182-F on 4/16/2018, which rescinds the enrollment requirement for providers who prescribe drugs to patients enrolled in Medicare Part D and for network providers and suppliers that furnish health care items or services to a Medicare beneficiary who receives his or her Medicare benefit through an MA organization. 

Medicare does not require providers to enroll for the sole purpose of ordering and referring, especially for residents in learning institutions as the physician overseeing actions for the provider is responsible for approving resident actions.

Related Content

• CMS Prescription Drug Coverage – General Information

Revised 7/29/2024