Reporting requirements for a legal business name (LBN) change

When an individual practitioner, group, or organization makes a change to their legal name or LBN, this change should be reported to the Medicare contractor within 90 days of the event.

Requests for name changes can be submitted via the Provider Enrollment, Chain, and Ownership System (PECOS) or by paper application: 

• Medicare Enrollment Application - Physicians and Non-Physician Practitioners (CMS-855I) 
• Medicare Enrollment Application – Clinics / Group Practices and Other Suppliers (CMS-855B)
• Medicare Enrollment Application - Institutional Providers (CMS-855A)
• Medicare Enrollment Application - Medicare Diabetes Prevention Program (MDPP) Suppliers (CMS-20134)

The individual's name must be updated with the Social Security Administration and the National Plan & Provider Enumeration System (NPPES) prior to updating the Medicare file since PECOS connects to these databases.

Note: This is also the time to update the name with the state licensure branch.

The group/organization's LBN must be updated with the Internal Revenue Service (IRS) and the National Plan & Provider Enumeration System (NPPES) prior to updating the Medicare file since PECOS connects to these databases.

Note: IRS document (i.e., CP-575, LTR 147C) is required to confirm the LBN change.

Please remember to submit an updated Electronic Funds Transfer (EFT) Agreement (CMS-588) to reflect the new name. (This applies to groups, organizations, individuals in private practice, and sole proprietors. Group members do not need to submit an EFT.)