How to complete a CMS-855 form

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Home ► faqs ► answers ► How to complete a CMS-855 form

Last Modified: 6/24/2022 Location: FL, PR, USVI Business: Part A, Part B

How to complete a CMS-855 form

Q: How do I complete a CMS-855 form? How can I be sure that I have everything I need?

A: Medicare enrollment applications/forms (CMS-855A, CMS-855B, CMS-855I, and CMS-855R) must be completed with accurate information and include all supporting documentation. First Coast offers several online resources to assist you during the provider enrollment process including:

• CMS-855 tutorials

• Provider enrollment Learning on Demand Center playlist -- View webinars, videos, and more

• Provider enrollment tips, terms, and specialty codes:

• Tips to expedite your Medicare enrollment process

• Commonly used provider enrollment terms and their definitions

• Medicare provider/supplier specialty codes

Access the Provider Enrollment Application Assistance Tool for more help in determining the appropriate enrollment form and documentation for submission.

First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.