In the past, all physicians who didn't bill Medicare for 12 consecutive months were deactivated from the Centers for Medicare & Medicaid Services Internet-based Provider Enrollment, Chain and Ownership System. In particular, this affected pediatricians, including pediatric nephrologists, who may see Medicare beneficiaries only on an infrequent basis. Since 2008, the American Academy of Pediatrics (AAP) Committee on Coding and Nomenclature has been advocating for a pediatric exception to the rule to reduce administrative burden.

Effective immediately, pediatricians will not be deactivated because they have not billed Medicare for a prolonged period. It will be essential to indicate specialty 37 (pediatric medicine) as your specialty designation on claim forms to ensure full advantage of this exception. More detailed information can be found at the Medicare Learning Network (www.cms.gov/MLNMattersArticles) in an article titled “Physicians and Non-Physician Practitioners (NPPs) Excluded from Deactivation in Medicare Due to Inactivity with Medicare” (article...

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