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Part B Insider (Multispecialty) Coding Alert

Medicare Card Transition:

Ensure Your Patients Are Getting Their MBIs in the Mail

The first wave of the Medicare card transition is complete.

With the Medicare card change-up underway, you should be using the Medicare Beneficiary Identifier (MBI) numbers on your claims immediately.

Reminder: CMS began mailing out new Medicare cards with MBIs in April to cut down on the prevalence of identity theft. “MBIs will replace the existing Social Security Number-based Health Insurance Claim Number (HICN) on the new Medicare cards and in the systems Medicare uses now,” CMS explains in a recent update. “Medicare will replace all current cards and SSN-based numbers by April 2019.”

CMS urges providers to “use the MBI to bill Medicare as soon as you get a Medicare patient’s new number” and to “use the transition period to make sure your systems can accept and transmit MBIs,” CMS guidance maintains.

Remind patients they “may use their new cards as soon as they start receiving them in the mail,” encourages Jean-Pierre Dalhouse, education outreach representative for Medicare Administrative Contractor (MAC) Noridian Healthcare Solutions in Fargo, North Dakota, in a recent webinar on the subject.

Know These MBI Basics

Each unique MBI will consist of 11 randomly generated alphanumeric characters that will be “non-intelligent.” In other words, they won’t have any special or hidden meaning, Dalhouse stresses.

CMS will use the numbers 0-9 and letters from A-Z in the MBIs, according to a CMS fact sheet. An exception to this rule is that the letters S, L, O, I, B, and Z will not be included.

Example: Your patient’s MBI might read 1EG4-TE5-MK73, according to CMS guidance.

However, “the dashes aren’t used as part of the MBI,” the agency explains. “They won’t be entered into computer systems or used in file formats.” And don’t worry about fitting the new numbers on the old forms, CMS says. “MBIs will fit on forms the same way HICNs do. You don’t need spaces for dashes.”

Moreover, every Medicare beneficiary will receive a new number, including spouses who may have previously had “similar HICNs,” advises CMS.

Follow Up to Ensure Patients Did Receive Their New Cards

Staff must remember to ask all Medicare beneficiaries for their MBIs, ensuring that the patients did receive the new cards. Also, all MACs now have secure MBI look-up tools for practices struggling with the card transition, according to MLN Matters release SE 18006.

Starting in October 2018, MBIs will be returned on remittance advice even if you sent the original claim with a valid and active HICN instead of an MBI.

Progress: CMS acknowledges that it’s completed the first wave of mailings to beneficiaries in Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia, the MLN Connects July 12 release says.

“We continue to mail new cards to people who live in Wave 2 states and territories (Alaska, American Samoa, California, Guam, Hawaii, Northern Mariana Islands, Oregon), as well as nationwide to people who are new to Medicare,” notes CMS. “We started mailing new Medicare cards to people with Medicare who live in Wave 3 states: Arkansas, Illinois, Indiana, Iowa, Kansas, Minnesota, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin.”

Tips and tools: Patients who did not receive a new card yet, may call 1-800-MEDICARE for assistance. Also, beneficiaries may log into to see if CMS mailed their cards. If the MBI was sent out, then “an official card” can be printed for immediate use, suggests MLN Connects. But, Medicare users must “create an account if they do not have one” to access the information.

Practices are also encouraged to print out copies of the “Still Waiting For Your Medicare Card” handouts for worried beneficiaries, which can be found on the CMS website, advises the agency.

Resources: To read the MLN Matters article on MBIs, visit

Review an up-to-date fact sheet on the Medicare card transition at