Last Modified: 12/8/2020
Location: FL, PR, USVI
Business: Part A, Part B
Q: When is the application fee required for processing provider enrollment applications?
A: With the exception of physicians, non-physician practitioners, physician group practices and non-physician practices, providers and suppliers that are (1) initially enrolling in Medicare, (2) adding a practice location, or (3) revalidating their enrollment information, must submit with their application:
• An application fee in an amount prescribed by CMS, and/or
• A request for a hardship exception to the application fee
Note: The fee for January 1, 2021, through December 31, 2021, is $599.
This requirement applies to applications that First Coast Service Options (First Coast) receives on or after March 25, 2011. Note that a physician, non-physician practitioner, physician group, or non-physician practitioner group that is enrolling as a DMEPOS supplier via the CMS-855S application must pay the required application fee.
Note: Do not mail application fee payments. Payments cannot be accepted by mail or phone.
For providers that continue to use the CMS-855 paper enrollment applications
, access https://pecos.cms.hhs.gov/pecos/feePaymentWelcome.do
to pay the application fee. For those who submit applications online via internet-based Provider Enrollment, Chain, and Ownership System (PECOS), as you proceed through the application process, if a fee is required, you will be prompted to submit your payment.
The application fee is non-refundable, except if it was submitted with one of the following:
• A hardship exception request that is subsequently approved
• An application that was rejected prior to the Medicare contractor’s initiation of the screening process
• An application that is subsequently denied as a result of the imposition of a temporary moratorium as described in 42 CFR 424.570
Even though the Centers for Medicare & Medicaid Services (CMS) will send on a regular basis to First Coast a listing of providers and suppliers that have paid the application fee, it is still encouraged that provider/suppliers send with their application a copy of the receipt that is received after making the payment.
To find out if your provider/supplier is required to pay the application fee, access the Application Fee Matrix
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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.