Thursday, March 20, 2008

What is a PTAN number?

When calling Medicare you will need to know your doctors Provider Transaction Access Number or PTAN. In short this is the doctors current legacy provider Number with Medicare.

I am not sure why they needed to make this step so confusing for billing offices (i.e. changing the name of it and when you ask them what it is they won't tell you making it seem mysterious) but if you don't have your PTAN number you aren't going to get assistance with Medicare.

In order to process your phone calls quickly it's best to have this information ready to shoot off:
*Provider Transaction Access Number (PTAN)
* The name of the office - This must be specific to the PTAN reported
* The Health Insurance Claim Number (HICN) of the patient in question
* The patient’s name as it appears on the Medicare card
* The date of service in question
* Any Remarks codes and descriptions from the Standard Provider Remittance (SPR) for the claim in question
* Your question
* Your contact information like telephone # and extension

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  1. I have tried to use every number in the book. Tax ID, NPI #, NPI TYPE 2 #, Medical Group #, U PIN # and nothing seems to work. Where can I get more information about this PTAN #?

  2. A PTAN is not the Tax ID, NPI, Medical Group, or UPIN number which is why you are having issues talking with Medicare's Customer Support.

    The PTAN is the doctors legacy Medicare ID#. Normally found in box 24J on a printed CMS HCFA and starts with a letter. Something like:


    If you visit the NPPES registry and search for your doctor it maybe listed as Medicare ID Type. It just depends on how the office registered his NPI #.

    You can also pull out the contract between Medicare and the doctor (credentials) and verify the ID# in the acceptance letter.

    Let me know if you still have issues with this #. I may need to call you to help you find the #.

    Like I said in my blog article I don't know why they had to change the name and make it so confusing for everyone!! (Your not alone many people ask me for help on this).

  3. PTAN is same as the old Medicare provider number, they are just giving a fancy name to an old number, to complicate everybody's life.

  4. A doctor just posted a comment to this article however; I won't release the comment because she left her personal contact information. The question was here is my NPI # what is my PTAN #?

    Unfortunately I can not tell you what your PTAN # is because it wasn't listed on the NPPES website so these are my suggestions for "finding" your PTAN #.

    1. When you credentialed with Medicare you were required to complete paperwork. Once the paperwork was approved Medicare sent you documentation of your Medicare Provider Number. This is your PTAN # - review the documentation.
    2. If you are billing claims correctly to Medicare and you are receiving Medicare Payments on the claims then you are currently billing the claim with your Legacy Medicare Provider #. Demand a paper claim and see what # is pulling to box 24J.
    3. If you are sending the Medicare claims electronically open the 837 transmission file and search for your Provider Transaction Access Number (PTAN) which consists of 5 to 10 characters comprised of numeric or alpha characters.

    Remember you will only have a Medicare Provider Number if you have credentialed with Medicare. When you are in net-work with Medicare you accept their Allowable Amounts and terms for treating patients under the Medicare Regulations.

    If you are the Dr and reading this I just left a voice mail for you with my contact information if you need additional assistance please call or leave another comment.

    Remember the Medicare Provider # can be called a PTAN #, Medicare PIN or Legacy #. They all mean the same thing to Medicare.

    Thank you,

  5. The facility that I work employs PTA's services individuals maintenance PT and OT therapies. They are not credentialed with Medicare and do not have their own PTANs, is there a "non par PTAN" that can be used rather than Zero Filling?

  6. this is quite helpful, thanks.

  7. Question, since all physicians were required to convert over to NPI #'s why does the old legacy number even matter?

  8. Hi, i am a new doctor looking to start my own practice. I currently do have a current PTAN number. I was just wondering. Will my practice (or company) need its own PTAN number or is the PTAN number linked to the tax ID number and that is how the company bills? if you can provide any information about this it will be helpful

  9. I have a question about PTAN numbers. In the course of a transfer of ownership, my NPI number and the PTAN that claims have been filed with in the past are for some mysterious reason not linked, according to the people at MDCR. They are now denying all my MDCR claims. I went back into the NPI website(even though the people at MDCR said it is not the NPI website changes that screwed it up)and changed all of my information back to the way it was before I entered my new practice info. But it didn't help. It apparently has something to do with the original credentialing. Could someone have left my NPI off when they credentialed the practice I work in way back when, and that is now causing my claims to be kicked out, saying that MDCR does not recognize my NPI number?

  10. Do you have the # For Medicare Trailblazers for Virginia

  11. If I have Medicare and Medicaid ID numbers in the states of OH and IN, do I need to repeat the process from scratch for an ID number in the state of Illinois? Also, does this automatically mean I have a PTAN number on file somewhere? I do have an NPI, but started practice within the last 5 years- would I still have a PTAN if that's an old system? Thank you!

  12. I'm the NY provider and I'm already billing Medicare for my services in NY, but I also have office in NJ. Do I need another P-TAN to submitt NJ claims?
    Going crazy please help!!!
    Thank you.