Tips for Using New CMS Medicare Beneficiary Identifier

PUBLISHED: Jul 25, 2019
Relevant to: All Healthcare Organizations

The Centers for Medicare and Medicaid Services (CMS) MLN Matter Article, New MBI: Get It. Use It offers helpful information for understanding and incorporating use of the new Medicare Beneficiary Identifier (MBI). Some tips in the article include:

  • The Medicare Beneficiary Identifier (MBI) uses numbers 0-9 and all uppercase letters except for S, L, O, I, B, and Z. These letters were excluded to avoid confusion when differentiating some letters and numbers (e.g., between “0” and “O”).
  • Ask your Medicare patients for their new Medicare card when they come for care. If they haven’t received a new card at the completion of their geographic mailing wave, give them the “Still Waiting for Your New Card?” handout (in English or Spanish) or refer them to 1-800-Medicare (1-800-633-4227).
  • You can look up MBIs for your Medicare patients when they don’t or can’t give them. Sign up for your reginal MAC portal to use the tool. You can use this tool even after the end of the transition period – it doesn’t end on December 31, 2019. Even if your patient is in a Medicare Advantage Plan, you can look up the MBI to bill for things like indirect medical education. Your patient’s Social Security Number (SSN) is required for the search and may differ from their Health Insurance Claim Number (HICN), which uses the SSN of the primary wage earner.
  • The MBI should be used the same way you use the HICN. Put the MBI in the same field where you’ve always put the Health Insurance Claim Number (HICN). This also applies to reporting informational only and no-pay claims. Don’t use hyphens or spaces with the MBI to avoid rejection of your claim. The MBI will replace the HICN on Medicare transactions including Billing, Eligibility Status, and Claim Status. The effective date of the MBI, like the old HICN, is the date each beneficiary was or is eligible for Medicare. Until December 31, 2019, you can use either the HICN or the MBI in the same field where you’ve always put the HICN. After that the remittance advice will tell you if we rejected claims because the MBI wasn’t used. It will include Claim Adjustment Reason Code (CARC) 16, “Claim/service lacks information or has submission/billing error(s).” along with Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”.
  • CMS encourages providers to start using patient’s MBI now. CMS will reject claims using the HCIN (HICN), with a few exceptions and reject all eligibility transactions starting January 1, 2020.

Want to read the full alert and receive alert emails?

Browse Additional Alerts