Announcing the Release of Revised and New CMS-855 Medicare Provider-Supplier Enrollment Applications
The US Office of Management and Budget recently approved changes to the Medicare Provider-Supplier Enrollment Applications (CMS-855) in order to update them from the 2008 versions, as well as the new CMS-855O application form used for the sole purpose of enrolling to order and refer items and/or services to Medicare beneficiaries. The revised and new forms are now available on the CMS Provider-Supplier website at http://www.CMS.gov/CMSForms/CMSForms/list.asp?filtertype=dual&filtertype=keyword&keyword=855.
Providers and suppliers enrolling for the sole purpose to order and refer are required to begin using the new CMS-855O form immediately. Providers and suppliers using the other CMS-855 forms to enroll in Medicare are encouraged to begin using the revised forms, though may continue to use the old forms through October 2011
Matthew D. Febbo, RPh
LCDR U.S. Public Health Service
Regional Pharmacist
Centers for Medicare and Medicaid Services
Division of Medicare Health Plans Operations
Philadelphia Regional Office
150 S. Independence Mall W, Suite 216
Philadelphia, PA 19106
matthew.febbo@cms.hhs.gov
Voice: 215-861-4196, Fax: 443-380-5782