Cms 855A PDF Details

The CMS 855A form is the Medicare Enrollment Application for Institutional Providers. This application is required for healthcare institutions billing Medicare for Part A services, covering both initial enrollment and updates to existing enrollment records.

Who Must Complete the CMS 855A

The following types of institutions must submit the CMS 855A application to participate in Medicare:

Enrollment Methods: PECOS vs. Paper

Medicare offers two methods to submit your enrollment application. You can apply through PECOS (Internet-based Provider Enrollment, Chain, and Ownership System), which allows for faster processing. Alternatively, you can complete the paper application and mail it to your Medicare Administrative Contractor (MAC).

Required Documentation

Before submitting your application, gather the following items:

Common Errors to Avoid

The following mistakes are responsible for most application rejections and processing delays:

Reviewing each section carefully before submission significantly reduces the chance of rejection.

Processing Timeline

After submitting your completed application, a Medicare Administrative Contractor will review it. Depending on your provider type, a state agency or accreditation organization may also conduct a survey. The review process typically takes 60 to 90 days. Once approved, you will receive your Medicare billing number and can begin billing for covered services.

Related CMS Enrollment Forms

Depending on your provider type, you may need additional enrollment forms. The CMS 855B form is used by physician group practices and other Part B suppliers. The CMS 855R form is used to reassign Medicare benefits to a group practice. DMEPOS suppliers submit the CMS 855S form. Additional Medicare resources are available through our Medicare forms collection.

QuestionAnswer
Form NameCms 855A
Form Length60 pages
Fillable?Yes
Fillable fields266
Avg. time to fill out34 min 8 sec
Other names855a mail form, 855a form, cms 855a form, cms information

How to Edit Cms 855A Online for Free

Our PDF editor makes it straightforward to complete the CMS-855A enrollment application online. Follow these steps to fill out and submit your application without difficulty.

Step 1: Open the CMS-855A Form

Click the orange "Get Form Here" button at the top of this page. The application opens directly in your browser with no software installation required.

Step 2: Enter the National Provider Identifier

cms 855a enrollment application empty fields to consider

Enter your organization's 10-digit NPI number in the National Provider Identifier section. The NPI is required for all Medicare enrollment applications. If your institution has multiple billing locations, each location that bills Medicare separately may require its own NPI entry.

Step 3: Complete the Core Information Sections

step 2 to entering details in cms 855a enrollment application

Fill in the required information across the main application sections:

  • Additional information: Legal organization name, tax ID, and business type.
  • Mailing address: The address where Medicare will send your Remittance Advice notices.
  • Practice locations: All locations where your institution serves Medicare beneficiaries.
  • Managing employees: Individuals with five percent or more ownership interest or managing control.

Step 4: Complete the Billing Number Information

Filling out cms 855a enrollment application stage 3

Select your reason for application in the Billing Number Information section. Options include:

  • New enrollment in Medicare
  • Adding a new practice location
  • Reactivating a Medicare enrollment
  • Voluntarily terminating Medicare enrollment
  • Reporting a change of ownership or control

If you are reporting a change of ownership, submit the application within 30 days for changes requiring prior CMS approval, or within 90 days for other reportable changes.

Step 5: Complete the Authorization and Signature

stage 4 to filling out cms 855a enrollment application

Enter all required information in the rights and responsibilities fields. The authorized official of your institution, meaning the individual with legal authority to enroll your organization in Medicare, must sign and date the application. An application submitted without this signature will be rejected by your Medicare Administrative Contractor.

Step 6: Review and Finalize

Entering details in cms 855a enrollment application stage 5

Before finalizing, review your completed application carefully. Confirm all required fields are filled in, all supporting documents are attached, and ownership and managing control information is fully disclosed. When satisfied that the application is complete and accurate, click the "Done" button to export the finalized form.

Step 7: Save and Submit

Make two or three copies of the completed application for your records. You can download the application as a PDF, send it by email, or print it for mailing. Mail the completed application along with all required supporting documents to your assigned Medicare Administrative Contractor.

Tips for a Successful Application

  • Consider submitting through PECOS online for faster processing.
  • Follow up with your MAC if you have not received confirmation within 60 days.
  • Update your enrollment record within 90 days of any reportable changes to your organization.
  • Keep copies of all submitted documents for future reference.

Frequently Asked Questions

What is the difference between the CMS 855A and CMS 855B?

The CMS 855B form is used by physician group practices and other Part B suppliers. The CMS 855A is for institutional providers billing Medicare for Part A services, such as hospitals and home health agencies.

Do I need an NPI to complete the CMS 855A?

Yes. All healthcare providers who transmit health information electronically in connection with covered transactions must have an NPI. Your organization's NPI is required to complete the Medicare enrollment application.

How long does Medicare enrollment take after submitting the CMS 855A?

The standard processing time is 60 to 90 days after a complete application is received. Applications missing required information or documentation will be returned, which can add additional weeks to the timeline. Submitting through PECOS typically results in faster processing than the paper method.

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