A provider who has opted out of the Medicare program will not complete a separate application to order or certify items/services for beneficiaries to other Medicare providers; instead, they should indicate they wish to order/certify as part of the opt out process.
CMS-855 enrollment application processing timeframes
Did you know CMS has defined timeframes for processing CMS-855 forms? Read on to learn more.
A provider is eligible to order or certify items or services for a Medicare beneficiary only if the individual meets both of the following criteria:
The following shows the information for the various applications:
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CMS-855A and CMS-855B
Mass immunization roster billers
Read this article if you are a roster biller for mass immunizations or interested in becoming one.
A provider’s legal business name (LBN) is the name registered with the IRS and appears on IRS documents, such as the CP-575, that contains a provider’s EIN or TIN. This is the name that should be put on the CMS-855 application.
Clinical nurse specialist (CNS)
View the qualification and documentation requirements for becoming a Medicare-enrolled clinical nurse specialist.
Speech-language pathologist (SLP)
Did you know the state-licensed speech-language pathologist (SLP) may include provisional or temporary licensure while...
Registered dietitian or nutrition professional
Read this article for information on enrolling in Medicare as a registered dietician.
Physical therapist (PT) in private practice
Read this article for instructions on enrolling in Medicare as a physical therapist.