Medicare Provider Enrollment Process

AAAs should think strategically before requesting their own Medicare provider number (as opposed to partnering with an existing Medicare provider). Once organizations (including 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 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 steps in this resource 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)