Portable X-Ray Suppliers (PXRS)

A PXRS can be simultaneously enrolled as a mobile IDTF, though they cannot bill for the same service. A PXRS requires a State survey, while a mobile IDTF does not (although an IDTF requires a site visit). A PXRS does not have a supplier agreement. All information can be found in CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 15, Section 15.4.2.5

Application Completion

Section 4 of the Application

In Section 4 of the Form CMS-855B, the PXRS must furnish certain information, including:

  • Whether it furnishes services from a mobile facility or portable unit. A PXRS can be either a mobile facility or portable unit, although it usually is the latter. A mobile IDTF, on the other hand, while it too can be either, is typically a mobile facility.
  • Base of operations.
    • This is where personnel are dispatched from and where equipment is stored. It may or may not be the same address as the practice location.
    • All geographic locations at which services will be rendered.
  • Vehicle information if the services will be performed inside or from the vehicle
  • If completing application via PECOS, ensure application questionnaire is answered correctly. CMS-855B, CMS-588 (Electronic Funds Transfer (EFT)) application will populate.
  • If completing application via paper, the following must be submitted:
  • A voided check or signed bank letter is necessary documentation for EFT portion of application
  • Must include legal business name (LBN) of the enrollment, routing and account number and practice address
  • Submit application fee
    • Fee is required for application. Can be paid on PECOS website
    • Select pay application fee on right-hand side under Helpful Links

Site Visits

Task Description
Initial application If a PXRS submits an initial application, a site visit will be ordered after the Noridian receives the tie-in notice (or approval letter) from the RO. This is to ensure that the supplier is still in compliance with CMS's enrollment requirements.
Revalidation If a PXRS submits a revalidation application, a site visit will be ordered. This is to ensure that the supplier is still in compliance with CMS's enrollment requirements. The contractor shall will make a final decision regarding the revalidation application after the site visit has been reviewed.
New/changed location If a PXRS is adding a new location or changing the physical location of an existing location, a site visit will be ordered after the Noridian receives the tie-in notice (or approval letter) from the RO. This is to ensure that the new/changed location is in compliance with CMS's enrollment requirements.
Reassignment PXRSs may receive reassigned benefits. A PXRS will not need to separately enroll as a group practice in order to receive them.

 

Effective Dates

Medicare can go back 30 days from when the application is submitted, or all signatures are received in PECOS.

An application can be submitted 60 days in advance of when the enrollment will be active.

Supporting Documents

  • IRS document when:
    • Initial enrollment
    • A change of legal business name
  • A voided check or signed bank letter is necessary documentation for EFT portion of application
  • Copies of licenses and registrations must be submitted for each vehicle, unless stated otherwise by CMS

Resources

 

Last Updated Tue, 06 Dec 2022 13:46:43 +0000