Article Detail - JA DME

Suppliers are urged to confirm beneficiary eligibility status on either the Noridian Medicare Portal (NMP) or the Interactive Voice Response (IVR). This verification helps identify when the beneficiary is in a Part A Skilled Nursing Facility (SNF) inpatient stay, in a SNF after the Part A stay has ended, undergoing a home health episode plan of care, or covered under hospice care. By assessing eligibility, suppliers can make well-informed decisions on whether to proceed with providing items or services, considering some items that may fall under consolidated billing requirements.

To streamline this process, suppliers are advised to utilize the Consolidated Billing Tool available on the Noridian Medicare website. This tool assists in determining whether a Healthcare Common Procedure Coding System (HCPCS) code is subject to consolidated billing requirements. For further details and additional references, please consult the Consolidated Billing page on our website, where the new Consolidated Billing Chart can be found.