Medicare Beneficiary Identifier (MBI)
The MBI is confidential like the SSN and should be protected as Personally Identifiable Information.
How to Obtain the MBI:
- Ask your patients for their cards. If they need a new card, refer them to the Your Medicare Card website
. - Use the MBI Lookup Tool in myCGS. The patient must give their first and last name, date of birth an SSN. Sign up for myCGS to use the tool. You may only use the MBI Lookup Tool when a Medicare patient doesn't or can't give you their MBI. The MBI is confidential, so you must protect it and use it only for Medicare-related business.
Calling Customer Service
When you call CGS, you must enter your patient's name and Medicare number during the validation process. Use MBI & Name Converter to get the correct numbers to enter on your telephone keypad.
Checking Medicare Eligibility
To protect patients from Medicare fraud, Medicare Administrative Contractors (MACs) will disable beneficiary eligibility information from Interactive Voice Response (IVR) systems. All MACs must do so by March 31, 2025.
CGS will disable eligibility information on February 28, 2025, at 5 pm CT (6 pm ET).
You must check eligibility using:
- myCGS DME Web Portal (secure online web portal)
- Billing agencies, clearinghouses, software vendors
- HIPAA Eligibility Transaction System (HETS)
See the Checking Medicare Eligibility
fact sheet for more information.
What to Do If the MBI Changes
Always check Medicare eligibility before you file a claim to Medicare. If you receive the error message "Invalid MBI", your patient's MBI may have changed.
How to Obtain the Changed/New MBI:
You should ask the patient for the new MBI. If they are not able to provide it to you, use the MBI Lookup Tool in myCGS. The patient must give their first and last name, date of birth an SSN.
If the patient has not received their new Medicare card with the new MBI yet, they may get their new Medicare ID by calling 1-800-Medicare or signing in to their medicare.gov account.
All the patient's information and claim data will be available under their current MBI. You may also use the new MBI to file claims for all dates of service.
Eligibility inquiries when the inquiry uses:
- A new MBI – We'll return all eligibility data.
- The old MBI and request date or date range overlap the active period for the old MBI – We'll return all eligibility data.
- The old MBI and request date or date range are entirely on or after the effective date of the new MBI – We'll return "Invalid MBI".
*If you use another system, see CMS HIPAA Eligibility Transaction System (HETS) web site for more information.
Claim Submission when the MBI Changes:
- Dates of service before the MBI change date – use the old or new MBI.
- Span-date claims with a "From Date" before the MBI change date – use the old or new MBI.
- Dates of service that are entirely on or after the effective date of the MBI change – use the new MBI.
For more information about obtaining and using MBIs please refer to the CMS MBIs Overview page.
Updated: 12.20.2024
Join Electronic Mailing List
Print
Bookmark
Email
Facebook
YouTube
LinkedIn
CGS Medicare App