What to Do If the MBI Changes
CMS recently sent letters to people with Medicare who may have been affected by a recent data breach
. They’re mailing approximately 47,000 new Medicare cards with a new MBI to those affected.
Always check Medicare beneficiary eligibility before you file a claim to Medicare. You can check eligibility through the myCGS portal or the Interactive Voice Response (IVR). If you receive the error message "Invalid MBI", your patient's MBI may have changed.
Medicare beneficiaries or their authorized representatives can ask to change their Medicare Beneficiary Identifiers (MBIs); for example, if the MBI is compromised. CMS can also change an MBI. It's possible for your patient to seek care before getting a new card with the new MBI.
How to Obtain the Changed/New MBI:
You should ask the beneficiary for the new MBI. If they are not able to provide it to you, use the MBI Lookup Tool in myCGS.
If the beneficiary has not received their new Medicare card with the new MBI yet, they may obtain their new Medicare ID by calling 1-800-Medicare or signing in to their medicare.gov account.
All the beneficiary'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 through myCGS or the IVR* 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, refer to the CMS HIPAA Eligibility Transaction System (HETS) web site for more information. The MBI Lookup Tool is only available through the MAC online portal.
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: 09.05.23
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