Billing
Medicare (via MACs) — EDI Basics for PT/OT/SLP
Enrollment touchpoints, 837/835 overview, and common setup pitfalls—written by billers who submit daily. Education only.
At a glance
- EDI enrollments are MAC‑specific; confirm your MAC’s portal/process
- 837P for claims; 835 for remits/ERA
- Direct connections often available after setup; clearinghouse routes remain a fallback
Common setup pitfalls
- Mismatched TIN/NPI/addresses between enrollments and claims
- ERA not linked correctly to claim submitter/receiver IDs
- Missing secondary/tertiary handling configuration
Education only; not billing, coding, or legal advice. Always follow CMS/MAC requirements and current rules.
Author: PBS EMR Billing Team · Updated: 2025‑10‑05