Hospitalist Have New Medicare Specialty Code Effective April 2017 – Are You Using It?

The Centers for Medicare & Medicaid Services (CMS) has issued an MLN Matters article to notify providers of a new physician specialty code for hospitalists, effective April 1, 2017.

The new code, C6, will allow hospitalists to self-designate their specialty on the Medicare enrollment application (CMS-855I or CMS-855O), or in the Internet-based Provider Enrollment, Chain and Ownership System.

CMS uses these Medicare physician specialty codes, which describe the specific types of medicine that physicians (and certain other suppliers) practice, for programmatic and claims processing purposes.

Medicare will recognize the code as a valid specialty for the following:

  • Ordering and certifying Part B clinical laboratory and imaging, durable medical equipment and Part A home health agency claims
  • Critical Access Hospital (CAH) Method II Attending and Rendering claims
  • Attending, operating, or other physician or non-physician practitioner listed on CAH claims

Also refer to thedocuments below:

The official instruction, CR9716, issued to your MAC regarding this change consists of two transmittals.

The first updates the “Medicare Claims Processing Manual” and itis available
at https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3637CP.pdf.

The second updates the “Medicare /Financial Management Manual” at
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R276FM.pdf.

If you would like more information about our hospitalist services   Call us at (877) 698-1741 or click here for our contact form.

Leave a Reply