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New Medicare Enrollment Application (For Physicians and Non-Physician Practitioners)

CMS received approval for a new Medicare Enrollment Application for physicians and non-physician practitioners (CMS-855I dated 12/2018). Many changes are minor; the major ones reduce provider burden:

  • Eliminated reporting for advanced diagnostic imaging, Clinical Laboratory Improvement Amendments number, and the Food and Drug Administration radiology certification number
  • Expanded instructions for individual and group affiliations to simplify reporting
  • Made it optional to list a contact person
  • Added electronic storage information for those who no longer keep paper records
  • Created a more logical data flow

You may begin using the new application immediately. Through April 30, Medicare Administrative Contractors will accept applications dated 7/2011, but after that, you have to use the new version.

Who is affected?

All physicians and other qualified healthcare professionals (as defined in section 1848(k)(3)(B) of the Social Security Act) must use the CMS-855I (or PECOS) to enroll in the Medicare program and receive a Medicare billing number.

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