All EFT requests are subject to a pre-certification period in which all accounts are verified by the qualifying financial institution before any Medicare direct deposits are made.
Enrollment: EFT enrollment does not constitute enrollment as a provider or supplier in the Medicare program.
Account confirmation: Include a confirmation of account information on bank letterhead or a voided check.
Where to send: Upload this form to PECOS or mail this form to the Medicare contractor that services your geographical area.
Each contractor: An EFT authorization form must be submitted for each Medicare contractor to whom you submit claims for Medicare payment.
| Question | Answer |
|---|---|
| Form Name | Form CMS-588 |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 42 |
| Avg. time to fill out | 7 min |
| Edition | 11/2023 |
| Where to send | PECOS, or the Medicare contractor that services your geographical area |
| Who signs | Authorized/Delegated Official |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | CMS-588, CMS 588, CMS588, 588 form, Form CMS-588, CMS EFT form, EFT Authorization Agreement |
| Official source | Form CMS-588 (Rev 11/2023), Centers for Medicare & Medicaid Services |
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