Update Your Medicare Enrollment to Reflect the EP Specialty Designation

Electrophysiologists are encouraged to update their Medicare enrollment information to reflect the new physician specialty designation for Electrophysiologists (specialty designation 21 —learn more).

Specialty codes are used by Centers for Medicare and Medicaid Services (CMS) for programmatic and claims processing purposes. Currently, there is a risk that claims can be denied as duplicate bills, when two physicians from the same group practice bill for patient evaluation services. By identifying yourself as an electrophysiologist, you may be able to be paid for an office visit for a patient who has seen a cardiologist on the same day.

The specialty designation also allows CMS and HRS to gather data about utilization and payment for electrophysiology services. Currently, there is no mechanism to determine electrophysiologists’ influence on Medicare utilization or payments. Work performed by electrophysiologists is captured under other physician specialty identifier codes. Within three years, there will be data to identify utilization trends in electrophysiology services, and changes in the patient populations.

To update your Medicare enrollment information, visit your Medicare Administrative Contractor's website, select the site's enrollment section, and utilize PECOS, the electronic enrollment portal to change your specialty designation.

For more information, contact Kimberley Moore, Director of Reimbursement and Regulatory Affairs, via e-mail.