Providers/Suppliers Not Eligible to Enroll

10.2.8 - Providers/Suppliers Not Eligible to Enroll (Rev.: 12356; Issued: 11-09-23; Effective: 01-01-24; Implementation: 01-02-24) Section 10.2.8 contains a non-exhaustive list of individuals and entities that frequently attempt to enroll in Medicare but are not eligible to enroll as one of the categories listed below. (For instance, an individual cannot enroll as a drug and alcohol rehabilitation counselor.) If the contractor receives an enrollment application from an individual/entity attempting to enroll as one of these categories below, the contractor shall deny the application -- with the exception of entities eligible to enroll using the Form CMS-20134, which is specific to the furnishing of MDPP services. An assisted living facility, for example, that also provides the DPP and is eligible to enroll as an MDPP supplier may enroll through the CMS-20134; however, this enrollment only pertains to the rendering of MDPP services. • Acupuncturist • Assisted Living Facility • Birthing Center • Certified Alcohol and Drug Counselor • Certified Social Worker • Drug and Alcohol Rehabilitation Counselor • Hearing Aid Center/Dealer • Intern (Graduate Medical Education) • Licensed Alcoholic and Drug Counselor • Licensed Massage Therapist • Licensed Practical Nurse • Licensed Professional Counselor • Master of Social Work • Medicare Beneficiaries • National Certified Counselor • Naturopath • Occupational Therapist Assistant • Physical Therapist Assistant • Registered Nurse • Speech and Hearing Center • State Medicaid Agency (SMA)(SMAs do not have an NPI and are not eligible to enroll in the Medicare program. If an SMA is enrolled or seeks enrollment as a provider or supplier in the Medicare program, the contractor shall deny or revoke its Medicare billing privileges using, respectively, § 424.530(a)(5)(ii) (denials) and § 424.535(a)(5)(ii) (revocations) as the basis.) • Substance Abuse Facility