Cms 838 Form: A Comprehensive Guide And Instructions

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The CMS-838 form is a crucial document for healthcare providers and suppliers who participate in the Medicare program. It is used to report information about ordering and referring physicians and non-physician practitioners, and is a key component of the Medicare claims process. In this article, we will provide a comprehensive guide to the CMS-838 form, including its purpose, instructions, and frequently asked questions.

What is the CMS-838 Form?

The CMS-838 form, also known as the " CMS-838: Form for Ordering/Referring Physicians and Non-Physician Practitioners," is a Centers for Medicare & Medicaid Services (CMS) form used to collect information about the ordering and referring physicians and non-physician practitioners who have ordered or referred Medicare-covered services. The form is typically completed by healthcare providers and suppliers who are required to report this information to Medicare.

Purpose of the CMS-838 Form

The primary purpose of the CMS-838 form is to ensure that Medicare payments are made accurately and efficiently. By reporting information about ordering and referring physicians and non-physician practitioners, healthcare providers and suppliers can help prevent errors and ensure that claims are processed correctly.

Who Needs to Complete the CMS-838 Form?

The CMS-838 form is required for healthcare providers and suppliers who participate in the Medicare program and need to report information about ordering and referring physicians and non-physician practitioners. This includes:

• Physicians and non-physician practitioners who order or refer Medicare-covered services
• Healthcare providers and suppliers who bill Medicare for services
• Durable medical equipment (DME) suppliers
• Home health agencies
• Hospices

How to Complete the CMS-838 Form

Completing the CMS-838 form is a straightforward process that requires careful attention to detail. Here are the steps to follow:

1. Section 1: Ordering/Referring Physician/Non-Physician Practitioner Information
   • Enter the name, address, and National Provider Identifier (NPI) of the ordering or referring physician or non-physician practitioner.
2. Section 2: Ordering/Referring Physician/Non-Physician Practitioner Contact Information
   • Enter the phone number and fax number of the ordering or referring physician or non-physician practitioner.
3. Section 3: Service Information
   • Enter the type of service ordered or referred (e.g., laboratory test, imaging study, etc.).
   • Enter the date of service.
4. Section 4: Certification
   • Sign and date the form to certify that the information provided is accurate and complete.

Tips for Completing the CMS-838 Form

• Make sure to use the correct NPI for the ordering or referring physician or non-physician practitioner.
• Use a separate form for each ordering or referring physician or non-physician practitioner.
• Keep a copy of the completed form for your records.
• Make sure to submit the form with your Medicare claim.

CMS-838 Form Instructions

Here are some additional instructions to keep in mind when completing the CMS-838 form:

• Use black ink: When completing the form, use black ink to ensure that the information is legible.
• Use a separate form for each ordering/referring physician/non-physician practitioner: Do not use the same form for multiple ordering or referring physicians or non-physician practitioners.
• Keep a copy for your records: Make sure to keep a copy of the completed form for your records.

CMS-838 Form FAQs

Here are some frequently asked questions about the CMS-838 form:

Q: Who needs to complete the CMS-838 form?

A: Healthcare providers and suppliers who participate in the Medicare program and need to report information about ordering and referring physicians and non-physician practitioners.

Q: What is the purpose of the CMS-838 form?

A: The primary purpose of the CMS-838 form is to ensure that Medicare payments are made accurately and efficiently.

Q: How do I complete the CMS-838 form?

A: Follow the steps outlined above, making sure to complete all required fields and sign and date the form.

Q: Can I use a separate form for each service ordered or referred?

A: No, use a separate form for each ordering or referring physician or non-physician practitioner.

Conclusion

The CMS-838 form is an important document for healthcare providers and suppliers who participate in the Medicare program. By following the instructions outlined above and completing the form accurately and completely, you can help ensure that Medicare payments are made accurately and efficiently. If you have any questions or concerns about the CMS-838 form, don't hesitate to reach out to your Medicare administrator or a qualified healthcare professional.