Key Takeaways
Aging and disability community-based organizations (CBOs) are generally well positioned to become Medicare Fee-for-Service (FFS) providers, providing benefits covered under Medicare Part B.
Follow the recommended steps for community-based organizations to obtain a Medicare Provider Number to bill for evidence-based programs.
They are geared toward non-profit AAAs that provide Medical Nutrition Therapy (MNT) and/or Diabetes Self-Management Training (DSMT).
Community-based organizations should think strategically before requesting their own Medicare provider number (as opposed to partnering with an existing Medicare provider). Once organizations (including area agencies on aging (AAAs)) become official Medicare providers, they are subject to periodic audits and other compliance requirements from the applicable Centers for Medicare and Medicaid Services (CMS) fiscal intermediary (also known as CMS Medicare Administrative Contractor (MAC).
Also, please note that an organization that only provides Diabetes Self-Management Training (DSMT) cannot obtain a Medicare provider number. Organizations must provide at least one other Medicare Part B service in order to obtain a Medicare number. Medical Nutrition Therapy (MNT) is an eligible primary service that will enable a program to obtain a Medicare billing number with DSMT as a secondary service. Providing both MNT and DSMT also establishes a viable cash flow that can cover costs of providing these services.
The following steps are suggestions for completing the required forms to obtain a Medicare provider number. They are geared toward non-profit AAAs that provide Medical Nutrition Therapy (MNT) and/or Diabetes Self-Management Training (DSMT).
