Provider Enrollment Required for Ordering, Referring and Attending Practitioners

Section 455.410(b) of the Affordable Care Act (ACA) requires providers to be enrolled in state Medicaid programs if they continue to order or refer services reimbursed by Fee-for- Service (FFS). All FFS claims must include the NPI of the enrolled ordering, referring and/or attending provider. Any practitioner who is eligible to enroll in NYS Medicaid FFS must be enrolled to continue to order or refer services that are paid by FFS.