Reminder: Requirements for billing DME, prosthetic, orthotics, medical supplies

Blue Cross Blue Shield of Michigan requires all durable medical equipment and medical supply providers who bill for custom prosthetic and orthotic services to have a Provider Transaction Access Number, or PTAN. This requirement includes all professional providers, including those who meet the Centers for Medicare & Medicaid Services exemption criteria.

Providers must obtain American Board for Certification accreditation for orthotics, prosthetics and pedorthics from a CMS-approved source and then request the PTAN from CMS to bill for custom P&O services. Once you have your 10-digit PTAN, you’ll need to enroll in the Blue Cross network with the ABC certification and the PTAN. Blue Cross may require a separate P&O provider identification number for billing custom P&O services and a DME provider PIN for billing DME and off-the-shelf P&O services.

Visit the Enrollment page at bcbsm.com or contact Provider Enrollment and Data Management at 1-800-822-2761 to request registration as a P&O provider. If your provider specialty isn’t updated, services billed to Blue Cross for custom P&O services will reject as not payable to your provider specialty and you’ll be liable for the charge and can’t bill the member.

Contact Provider Enrollment and Data Management for additional information to update your provider enrollment status.