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New Physician Specialty Code for Centralized Flu


The Centers for Medicare & Medicaid Services (CMS) established a new non-physician practitioner specialty code for Centralized Flu effective January 1, 2013. The new non-physician practitioner specialty code for Centralized Flu is C1 and is only applicable to the CMS-855B enrollment application. Make sure that your billing staffs are aware of this change for 2013.

Medicare physician/non-physician practitioner specialty codes describe the specific/unique types of medicine that physicians and non-physician practitioners (and certain other suppliers) practice. Physicians self-designate their Medicare physician specialty on the Medicare enrollment application (CMS-855B) or Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) when they enroll in the Medicare program. However, non-physician practitioners are assigned a Medicare specialty code when they enroll. The specialty code becomes associated with the claims submitted by that physician or non-physician practitioner. Specialty codes are used by CMS for programmatic and claims processing purposes and the new code for Centralized Flu, C1, will be added to PECOS and recognized as the non-physician practitioner code for Centralized Flu.

Reference: http://cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM7884.pdf

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