There are times when a Medicare Beneficiary Identifier (MBI) may change. People with Medicare or their authorized representatives can request an MBI change. CMS can also initiate a change to an MBI (for example, if the MBI is compromised). There are different scenarios for using the old or new MBIs:
Fee-For Service (FFS) claims submissions with:
- Dates of service before the MBI change date – use the old or new MBI
- Span-date claims with a “From Date” before the MBI change date – use the old or new MBI
- Dates of service that are entirely on or after the effective date of the MBI change – use the new MBI
FFS eligibility transactions when the inquiry:
- Uses new MBI – we will return all eligibility data
- Uses the old MBI and request date or date range overlap the active period for the old MBI – we will return all eligibility data and the old MBI termination date
- Uses the old MBI and request date or date range are entirely on or after the effective date of the new MBI – we will return an error code (AAA 72) of “invalid member ID”
When the MBI changes, we ask people with Medicare to share the new MBI with you. You can also get the MBI from your Medicare Administrative Contractor’s secure MBI lookup tool.
Remember:
To ensure people with Medicare continue to get health care services, you can continue to use the Health Insurance Claim Number through December 31, 2019, or until your patient brings in their new card with the new number.
We finished mailing most cards to people with Medicare who live in Wave 1 states: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. If someone with Medicare says they did not get a card: