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Submitted by M5FS on Thu, 12/26/2019 - 18:16
Important Updates: Medicare Enrollment Applications & Tip Sheet on State Coverage of Part B Deductible

Submit All Required Documentation with Your Medicare Enrollment Applications

As you submit your Opioid Treatment Programs’ (OTP) enrollment applications, make sure you include all required documentation. If you submit an application without all documentation, it will delay processing and may impact your ability to bill Medicare for services beginning on January 1, 2020.

Before submitting your application, make sure you include:

  • Signed provider agreement (PDF)
  • Detailed organizational chart (like the one used for SAMHSA certification)
  • Names, contact information, and Tax Identification Numbers (TINs) and/or Social Security Numbers (SSNs) for all individuals or organizations with managing control and/or ownership interest in the OTP
  • Medicare enrollment application fee; paid online through PECOS or the Medicare Enrollment for Providers and Suppliers webpage for paper applications
  • Completed Electronic Funds Transfer Form (PDF) - Bank account must be in the name of the enrolling OTP and must match the NPI registry
  • Your accurate legal business name (as documented by the IRS) - used on both the enrollment application and in the National Plan and Provider Enumeration System (NPPES).


SAHMSA Certification Letters

If SAMHSA certified your OTP before November 1, 2019, you no longer need to submit a copy of the SAHMSA Certification Letter with your Medicare application.

We encourage OTPs to enroll in Medicare as soon as possible so you can bill for services beginning January 1, 2020. Review our enrollment fact sheet for a step-by-step guide through the process.


Read the New Tip Sheet on State Coverage of Medicare Part B Deductible for Dually Eligible Patients

The Medicare Part B annual deductible applies to opioid use disorder treatment services. For the majority of individuals dually eligible for Medicaid and Medicare, state Medicaid agencies are liable for the Medicare Part B deductible, subject to certain limits. The new Tip Sheet for Opioid Treatment Program (OTP) Providers Serving Dually Eligible Individuals: State Coverage of the Medicare Part B Deductible (PDF) gives an introduction to the Part B deductible and how OTPs can get Medicaid payment for this deductible when treating dually eligible individuals. It also gives information about enrolling in Medicare and Medicaid, the Medicare claims crossover process, and how to find additional information.