Corporate

May 21, 2019

January 1, 2020: Seven Months To Go and Counting!

Beginning January 1, 2020, you MUST submit your home health and hospice billing transactions using the Medicare Beneficiary Identifier (MBI) regardless of the dates of service. Billing transactions include home health requests for anticipated payments (RAPs), final claims, hospice notice of elections (NOEs) and claims. Refer to information below about the few exceptions that apply, allowing you to submit either the HICN or the MBI.

CGS encourages home health and hospice providers to begin submitting the MBI before the end of the transition period, December 31, 2019. For information about how to get the MBI, refer to the "Don't Wait: Submit Your Patient's MBIs on Claims Now!" article.

CGS is monitoring MBI submissions to ensure providers are ready for this transition. The data below shows the percentage of home health and hospice claims submitted in April with the MBI for each of our primary states.

April Home Health and Hospice MBI Submissions by State

April MBI Submission Percentage

Exceptions

Below are the few exceptions when you can use either the Health Insurance Claim Number (HICN) or the MBI on or after January 1, 2020. For additional information about the exceptions, refer to the SE18006External PDF Medicare Learning Network article.

  • Appeals – You can use either the HICN or MBI for claim appeals and related forms. This includes the CGS Jurisdiction 15 Redetermination Request FormPDF.
  • Claim Status Query – You can use the HICN or MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you are checking the status of a claim with a date of service on or after January 1, 2020, you must use the MBI.
  • Span-Date Claims – You can use the HICN or the MBI for home health claims and request for anticipated payments (RAPs) (type of bill 32X) if the "From" date is before the end of the transition period (December 31, 2019). If the Medicare beneficiary is admitted to home health care before December 31, 2019, you can submit the episode's RAP with either the HICN or the MBI; however, you must use the MBI when you submit the final claim that corresponds with the RAP.

Don't wait till January 1, 2020, to start submitting your patient's MBI on your claims! If you have it, submit it! If you don't have it, get it!

Refer to the CMS New Medicare Card ProjectExternal Website webpage for additional information regarding this initiative.

If you have questions, please contact the Home Health and Hospice Provider Contact Center at 1.877.299.4500 and select Option 1.

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