CCNs

CMS Certification Numbers

Preface

A CMS Certification Number is a standardized^State Operations Manual, CMS publication number 100-07 sequence of alphanumeric characters that uniquely identify health care providers and suppliers who interact with the United States Medicare and Medicaid programs.

The CCN is used to track provider agreements and cost reports. The NPI¹ and PTAN² are tied to an entity’s CCN. The RO³ (not the SA⁴ or MAC⁵) assigns the CCN and maintains adequate controls.

In 2007, the CCN replaced the following terms:

• Medicare Provider Number
• Medicare Identification Number
• OSCAR Number⁶

CCN Format

The canonical format observes the following constraints:

1. Strings represented as sequences of UTF-8 characters.
2. Only characters in the Latin Alphabet are used:
   • Uppercase (U+0041 - U+005A)
   • ASCII Digits (U+0030 - U+0039)
3. Providers -> 6 characters
4. Suppliers -> 10 characters

and reflects the following structure, by character position:

• 1:2 -> Entity’s State Code⁷.
• 3 -> Facility Type/Supplier Type. Otherwise, part of Sequence Number.
• 4 -> Subunit’s Parent Facility Type. Otherwise, part of Sequence Number.
• 5 -> Part of Sequence Number.
• 6 -> Emergency Hospital Type. Otherwise, part of Sequence Number.
• 7:10 -> Only for Suppliers, part of Sequence Number.

Because the structure of the CCN depends on the type of Provider, Supplier, or Facility it is describing, the following examples are provided:

• ProviderCCN
• MedicareProviderCCN
• MedicaidOnlyProviderCCN
• IPPSExcludedProviderCCN
• EmergencyHospitalCCN
• SupplierCCN

1	2	3	4	5	6
6	7	0	0	5	5

Providers Vs. Suppliers

Medicare differentiates between providers and suppliers, the general distinction being that providers are parties who care for patients awaiting, receiving, or recuperating from treatment by intervening practitioners while suppliers include those who furnish goods and services used in care and treatment.

Medicare providers and suppliers are defined at 42 CFR 498.2. In Medicare, as specified in §1861(u) of the Social Security Act, providers include:

• Hospitals
• Critical Access Hospitals (CAHs)
• Skilled Nursing Facilities (SNFs)
• Home Health Agencies (HHAs)
• Hospices
• Comprehensive Outpatient Rehabilitation Facilities (CORFs)

Under §1835(a)(2) of the Act, clinics, rehabilitation agencies, or public health agencies are included as providers if such clinic or agency meets the requirements of §1861(p)(4)(A).

Community Mental Health Centers (CMHC) are providers of services for partial hospitalization services only. Providers must meet CoPs or Requirements for SNFs to participate in Medicare. (See definitions at 42 CFR 498.2.)

Suppliers that must meet conditions for coverage/certification to participate in Medicare are:

• Portable X-Ray Services (PXRF)
• End-Stage Renal Disease (ESRD) facilities
• Ambulatory Surgical Centers (ASC)
• Organ Procurement Organizations (OPO)
• Rural Health Clinics (RHC)
• Federally Qualified Health Centers (FQHC)
• Laboratories (CLIA)

The above types of suppliers are distinguished from other suppliers, e.g., pharmacies, prosthesis suppliers, etc., for which there are no conditions for coverage or certification, and which qualify for Medicare through the enrollment process.

Medicaid, by contrast, uses provider generically to include all health care vendors. (See 42 CFR 431.107(a) and 433.37) and does not distinguish between providers and suppliers. Section 1902(a)(27) of the Act provides for agreements with every person or institution providing services under the State plan. 42 CFR 431.107(a) refers to all providers of services (including individual practitioners and groups of practitioners).

---

1. National Provider Identifier

2. Provider Transaction Account Number

3. CMS Regional Office

4. State Agency

5. Medicare Administrative Contractor

6. Online Survey, Certification, and Reporting System.

7. includes certain countries and territories.