New Medicare Cards Coming Soon

Posted on March 6, 2018 by Bobbie Guidry

The Centers for Medicare & Medicaid Services (CMS) is required to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. This will have an impact on how providers submit claims.  

A new, unique Medicare Number, a Medicare Beneficiary Identifier (MBI), will replace the SSN-based Health Insurance Claim Number (HICN) on each new Medicare card. Starting in April, CMS will begin mailing new Medicare cards to all people with Medicare on a flow basis by geographic location and other factors. Minnesotans are scheduled to receive their new cards with the third of seven groupings, planned for after June 2018.

There will be a transition period (April 1, 2018 – Dec. 21, 2019) where you can use either the HICN or the MBI to exchange data with CMS. During the transition period, CMS monitor the use of HICNs and MBIs to see how many of you are ready to use only MBIs by January 2020; and will also actively monitor the transition and adjustment to the new MBIs to make sure of their wide-spread adoption so Medicare operations aren’t interrupted. 

Starting Jan. 1, 2020, you must submit claims using MBIs (with a few exceptions), no matter what date you performed the service.

Medicare Plan Exceptions:

• Appeals - People filing appeals can use either the HICN or the MBI for their appeals and related forms.
• Adjustments - You can use the HICN indefinitely for some systems (Drug Data Processing, Risk Adjustment Processing, and Encounter Data) and for all records, not just adjustments.
• Reports – CMS will use HICN on these reports until further notice:
  • Incoming to CMS (quality reporting, Disproportionate Share Hospital data requests, etc.)
  • Outgoing from CMS (Provider Statistical & Reimbursement Report, Accountable Care Organization reports, etc.)

Fee-for-Service claim exceptions:

• Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
• Claim status query - You can use either the HICN or MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before Jan. 1, 2020.  If you're checking the status of a claim with a date of service on or after Jan. 1, 2020, you must use the MBI.
• Span-date claims - You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments, and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before Dec. 31, 2019. You can submit claims received between April 1, 2018 and Dec. 31, 2019 using the HICN or the MBI.  If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before Dec. 31, 2019, but stops getting those services after Dec. 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after Dec.31, 2019.
• Incoming premium payments - People with Medicare who don't get SSA or RRB benefits and submit premium payments should use the MBI on incoming premium remittances. CMS will accept the HICN on incoming premium remittances after the transition period. (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)

For More Information, see Mailing Strategy; Patient Question Guidelines; and New Medicare Card Overview; and Provider Specific Information.