Add or update reassignment information on the new version of the CMS-855B
The CMS-855B - Medicare Enrollment Application - Clinics/Group Practices and Other Suppliers, has been revised. The biggest change to the form is a group’s ability to submit reassignment information in section 4H, and to include the individual practitioner’s signature in section 15E, as needed. Multiple reassignments can be reported by submitting separate sections 4H and 15E, along with the appropriate authorized or delegated official signatures.
Please note:
- If an individual is newly enrolling in Medicare, the CMS-855I is required and the reassignment information can be added to that application.
- Revalidation alert – groups/organizations should not include reassignment information when submitting a revalidation on the CMS-855B (unless there is new information being added, changed, or terminated).
Other notable changes on the revised CMS-855B:
- Section 1A has a new submittal reason for providers who intend to enroll in Medicare solely to participate in Medicaid or another health care program and do not intend to bill Medicare for services.
- Home Infusion Therapy has been added as a new supplier type.
- The medical records correspondence address has been added.
- Physician assistant (PA) employer arrangement section has been removed. PAs will now be reassigned as other individual provider types in sections 4H and 15E.
- Section 4A expands practice location types to include separate options for Business Office for Administrative/Telehealth Use Only and Home Office for Administrative/Telehealth Use Only.
- The electronic storage collection in 4C2 has been updated to collect information of where electronic records are stored.
- Sections 5 and 6 – Ownership Interest and/or Managing Control for organizations and individuals has broken out relationships for direct and indirect ownership, and general and limited partners.
Refer to Completing the Medicare CMS-855B enrollment application for helpful hints in completing the application.