Provider Enrollment

Published 09/19/2022

No, third-party billers and clearinghouses cannot request a provider's Railroad Medicare PTAN. A Provider Transaction Access Number (PTAN) can only be requested by the provider or a provider representative directly employed by the provider. For more information on requesting a Railroad Medicare PTAN, please see our article Getting Started With Railroad Medicare Billing.

Last Reviewed: 9/19/2022

Yes, a billing agency or clearinghouse can make changes if the following information is verified. The request must be in writing as Provider Enrollment will no longer accept telephone requests to update a record or enroll a provider.

  • NPI
  • PTAN and
  • Tax ID

Last Reviewed: 9/19/2022

No. Provider enrollment revalidation is completed by the jurisdictional Medicare Administrative Contractors (MACs).

Last Reviewed: 9/19/2022

You will only need to notify us if the additional practice location is in a different contractor locality, or if you have been assigned a new NPI(s) for the location.

Last Reviewed: 9/19/2022

Yes, you need to notify Railroad Medicare when a provider or practice name has changed. Please first notify your local Part B Medicare Administrative Contractor (MAC). Once you have received confirmation that the provider’s record has been updated by your MAC, please allow 7–14 business days before sending notification to Railroad Medicare.

You can fax or send written notification of the change to our Provider Enrollment unit. Please send your request on your provider/practice letterhead and include the following information:

  • Provider’s name
  • Railroad Medicare PTAN
  • NPI
  • Tax Identification Number
  • Contact information
  • Explanation of what needs to be changed

You can fax the request to (803) 382–2415 or mail the request to:

Palmetto GBA Railroad Medicare
Attention: Provider Enrollment
PO Box 10066
Augusta, GA 30999

Provider Enrollment does not accept telephone requests to update a record or enroll a provider.

Last Reviewed: 9/19/2022

Yes, you need to notify Railroad Medicare when you have changed a provider’s address with your local Medicare Administrative Contractor (MAC). Once you receive confirmation that the address has been updated with your MAC, please allow 7–14 business days before sending notification to Railroad Medicare.

You can fax or send written notification of the address change to our Provider Enrollment unit. Please send your request on your provider/practice letterhead and include the following information: 

  • Railroad Medicare PTAN
  • NPI
  • Tax Identification Number
  • Contact information
  • Prior/old address
  • New address 
  • Copy of Part B MAC notice confirming address change has been completed

You can fax the request to (803) 382–2415 or mail the request to: 

Palmetto GBA Railroad Medicare
Attention: Provider Enrollment
PO Box 10066
Augusta, GA 30999

Provider Enrollment does not accept telephone requests to update a record or enroll a provider.

Last Reviewed: 9/19/2022

No. That documentation is not needed for our records and will be returned. 

Last Reviewed: 9/19/2022

Please complete the address change with your local Medicare Administrative Contractor (MAC) before submitting the change to Railroad Medicare. Once you receive confirmation that the address has been updated with your MAC, please allow 7–14 business days before sending notification to Railroad Medicare.

You can fax or send written notification of the address change to our Provider Enrollment unit. Please send your request on your provider/practice letterhead and include the following information:

  • Railroad Medicare PTAN
  • NPI
  • Tax Identification Number
  • Contact information
  • Prior/old address
  • New address
  • Copy of Part B MAC notice confirming address change has been completed 
You can fax the request to (803) 382–2415 or mail the request to:
 
Palmetto GBA Railroad Medicare
Attention: Provider Enrollment
PO Box 10066
Augusta, GA 30999
 
Provider Enrollment does not accept telephone requests to update a record or enroll a provider.

Last Reviewed: 9/19/2022

Please first notify your local Part B Medicare Administrative Contractor (MAC). Once you have received confirmation that the provider’s record has been updated by your MAC, please allow 7–14 business days before sending notification to Railroad Medicare.

You can fax or send written notification of the change to our Provider Enrollment unit. Please send your request on your provider/practice letterhead and include the following information:

  • Provider's name
  • Railroad Medicare Provider Transaction Access Number (PTAN)
  • National Provider Identifier (NPI)
  • Tax Identification Number
  • Contact number
  • Explanation of what needs to be changed
    • Billing address – Include new billing address 
    • Practice address – Include new practice address
    • Practice name – Include new practice name
    • Provider's name – Include provider’s new name 
    • Provider retired – Include date provider retired
    • Provider left group – Include date provider left group 

You can fax the request to (803) 382–2415 or mail the request to: 

Palmetto GBA Railroad Medicare
Attention: Provider Enrollment
PO Box 10066
Augusta, GA 30999

Provider Enrollment does not accept telephone requests to update a record or enroll a provider.

Last Reviewed: 9/19/2022

Once Railroad Medicare receives your request for a PTAN, processing can take up to 30 calendar days to complete. When your PTAN is issued, Provider Enrollment will send you a letter with your Railroad Medicare PTAN information.

If you are already enrolled with your local Part B Medicare Administrative Contactor (MAC) and have a claim to submit for a Railroad Medicare patient, you will request a Railroad Medicare PTAN using the Railroad Medicare PTAN Lookup and Request Tool at www.palmettogba.com/RR/PTAN. The Railroad Medicare PTAN Tool and Request Tool will assign and release most new PTANs the day they are requested. Some requests may require research and you will be advised to allow 30 calendar days for processing and to return to the tool to retrieve your PTAN information. To learn more, please see our article Using Railroad Medicare's Online PTAN Lookup and Request Tool.

If you recently enrolled with your local MAC, please wait 14 business days from the date you receive your local MAC PTAN before using this tool.

If you meet an exception to bill paper claims, you have the option to submit a CMS-1500 claim form to begin the enrollment process. Once your claim is received, allow 30 days for Provider Enrollment to verify your Part B enrollment and assign a Railroad Medicare PTAN. Once the Railroad Medicare PTAN is assigned, your claim will be released for processing. Our article CMS Claim Filing Instructions provides helpful information on how to submit a paper claim to us.

Last Reviewed: 9/19/2022

No. Medicare is required to use "Return Service Requested" envelopes for all hardcopy remittance advices and checks that are mailed to providers and suppliers. If the provider address is no longer valid, the post office will return the undeliverable mail to the Medicare contractor. To have your address updated with Railroad Medicare, you will first need to submit a CMS Form-855I to your local Part B Medicare Administrative Contractor (MAC). Once you receive confirmation that the address has been updated with your MAC, please allow 7–14 business days before sending notification to Railroad Medicare.

You can fax or send written notification of the address change to our Provider Enrollment unit. Please send your request on your provider/practice letterhead and include the following information:

  • Railroad Medicare PTAN
  • NPI
  • Tax Identification Number
  • Contact information
  • Prior/old address
  • New address 
  • Copy of Part B MAC notice confirming address change has been completed

You can fax the request to (803) 382–2415 or mail the request to: 

Palmetto GBA Railroad Medicare
Attention: Provider Enrollment
PO Box 10066
Augusta, GA 30999

Provider Enrollment will not accept telephone requests to update a record or enroll a provider.

Last Reviewed: 9/19/2022

No, when your MAC enrollment status changes, the same changes apply to Railroad Medicare. If you are revoked or suspended from billing your local MAC, you cannot bill Railroad Medicare.

Last Reviewed: 9/19/2022

In order to respond to written inquiries, Medicare regulations mandate that we verify the requestor is a Railroad Medicare provider. If you submit your request on your company or practice's letterhead, the letterhead must:

  • Include the name of the provider
  • Pay to address on file with the local carrier
    • NPI
    • The provider’s Railroad Medicare PTAN
    • Tax Identification Number (TIN)

Last Reviewed: 9/19/2022

A Railroad Medicare PTAN for an individual provider or a supplier will be nine digits in one of the following formats:

  • Nine numbers,
  • Letter P followed by eight numbers; or
  • Letter Q followed by eight numbers

A Railroad Medicare PTAN for a provider group will be six digits in one of the following formats:

  • One letter followed by five numbers; or
  • Two letters followed by four numbers

Last Reviewed: 9/19/2022

Your Railroad Medicare effective enrollment date matches your effective enrollment date with your local Medicare Administrative Contractor (MAC).

Last Reviewed: 9/19/2022

The "Request for Railroad Medicare PTAN for Electronic Submitters" form was replaced with our Railroad Medicare PTAN Lookup and Request Tool. Providers use this tool to request a new Railroad Medicare PTAN, and to verify or obtain existing Railroad Medicare PTANs. 

Last Reviewed: 9/19/2022

Medicare requires that each provider have a unique PTAN for processing claims. Claims are processed within each Medicare Administrative Contractor's systems. Because Railroad Medicare is processing outside of your local MAC's systems, a unique PTAN is required for Railroad Medicare claims.

Last Reviewed: 9/19/2022

 

After submitting a request for a new Railroad Medicare Provider Transaction Access Number (PTAN) through our PTAN Lookup and Request Tool, please allow 30 calendar days for processing and then return to the tool to verify your PTAN status. To check the status, you will need to enter the same Local Medicare Administrative Contractor (A/B MAC) PTAN, NPI and Tax Identification Number combination that you entered on your original PTAN request, along with your contact information. The Reference Number of the original request is optional.

You can access the Railroad Medicare PTAN Lookup and Request Tool at www.palmettogba.com/RR/PTAN.

Last Reviewed: 9/19/2022