Ordering and referring
The flag is about claim acceptance, not about whether a license is current. OIG exclusion is a different file.
Source: CMS Ordering and Referring data and the Opt Out Affidavits dataset. Page read October 14, 2026.
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Definition · Provider identifiers and enrollment
Ordering and referring
Eligible to order and refer means the NPI is on the CMS file of providers whose orders and referrals Medicare will accept. The Medicare opt-out file also carries this flag. An opt-out does not by itself remove the flag. The opt-out lookup is at /medicare-opt-out-lookup.
Questions
Ordering and referring, answered
Does an opt-out remove the ordering flag?
Not by itself. The opt-out file has its own eligible-to-order field. Read that field on the row. Do not infer it from the opt-out date.