Physicians and non-physician practitioners: Revised Medicare enrollment application required November 1

If you don’t use the Provider Enrollment, Chain and Ownership System (PECOS), use the revised CMS-855I (Medicare Enrollment Application - Physicians and non-physician practitioners) to enroll or update your information. Starting November 1, 2023, you must use the revised form.

Form updates:

• Combines the CMS-855I and CMS-855R paper applications and discontinues the CMS-855R.
• Removes physician assistant employer arrangements.
• Recognizes physicians and non-physicians who provide acupuncture services.
• Identifies compact licenses.
• Adds new physician specialties.
• Expands practice location types to include telehealth.

Visit Medicare enrollment for providers and suppliers for more information, including an CMS-855I instructional guide. To enroll and update your information more quickly and easily, use PECOS.