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Medicare Requirements Bypass for LTC Provider Enrollment

Last updated on 3/8/2022

Effective immediately, the Long-Term Care (LTC) provider enrollment process has been updated to allow applicants to bypass Medicare requirements by selecting Medicare-waiver options in the enrollment application.

LTC providers need to complete the following fields in the Program Specific Questions section of the Provider Enrollment and Management System (PEMS) application:

  1. Select “No” to the “Are you using a Medicare certification number for this location?” question.
  2. Check to attest to the Medicare Billing Acknowledgement.
  3. Select the second Medicare Waiver Request option.
  4. Complete the Medicare Waiver box by indicating the LTC program does not require Medicare enrollment.

LTC providers can update their Medicare number by submitting the PEMS Existing Enrollment request and providing the updated Medicare information in the Program Specific Questions section of the Practice Location Information: Programs and Services Participation subpage.

The PEMS enrollment process will be updated to remove Medicare requirements for LTC Program enrollment applications at a later date. Future articles about this change will be on the TMHP LTC webpage. For more information about PEMS, refer to The Benefits of PEMS guide.