Which Providers Cannot Enroll in Medicare?

Each year certain providers attempt to enroll in the Medicare program to participate and bill for services. The Centers for Medicare & Medicaid Services (CMS), however, instructs its contractors that review and process enrollment applications, to deny applications from certain providers ineligible to participate with Medicare.

Which providers are on the ineligible list? CMS has stated that the following providers cannot enroll:

  • Acupuncturist
  • Assisted Living Facility
  • Birthing Center
  • Certified Alcohol and Drug Counselor
  • Certified Social Worker
  • Drug and Alcohol Rehabilitation Counselor
  • Hearing Aid Center/Dealer
  • Licensed Alcoholic and Drug Counselor
  • Licensed Massage Therapist
  • Licensed Practical Nurse
  • Licensed Professional Counselor
  • Marriage Family Therapist
  • Master of Social Work
  • Mental Health Counselor
  • National Certified Counselor
  • Occupational Therapist Assistant
  • Physical Therapist Assistant
  • Registered Nurse
  • Speech and Hearing Center
  • Substance Abuse Facility

Medicaid State Agencies are also not allowed to enroll as a provider or a supplier in the Medicare program.

If you have questions regarding Medicare enrollment, participation, revalidation, denial, or have other health law question please contact our office