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2015 Updates for Medicare Provider Enrollment

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Two updates will affect Medicare provider enrollment for 2015.

Revised CMS 855R

Physicians, non-physician practitioners, providers, and suppliers must use the revised CMS 855R (Reassignment of Benefits) application beginning June 1, 2015.

CMS 855R is used by physicians and non-physician practitioners to reassign Medicare payments or terminate a reassignment of Medicare benefits after enrollment in the Medicare program or make a change in their reassignment of Medicare benefit information.

The revised CMS 855R application will be available for use on the CMS.gov website as of December 29, 2014. MACs may accept both the current and revised versions of the CMS 855R through May 31, 2015, after which the revised CMS 855R application will be required to be submitted. After May 31, 2015, MACs will return any newly submitted CMS 855R applications on the previous version (07/11) to the provider/supplier with a letter explaining that the CMS 855R has been updated and the current version of the CMS 855R (11/12) must be submitted.

The revised CMS 855R has been streamlined and some sections have been re-ordered for clarity. The revised form includes an optional section for primary practice location address. This information is shared with other programs such as Physician Compare to help beneficiaries identify where their physicians are primarily practicing. This address must be one that is affiliated with the individual/organization where the benefits are being reassigned.

In lieu of the CMS 855R, providers also can submit these changes to Medicare using the Internet-based Provider Enrollment, Chain and Ownership System (PECOS).

For current forms for the Medicare program, visit your Medicare Administrative Contractor’s website. (For Indiana and Michigan providers, visits WPS Medicare.) For more information about the updated CMS 855R, review the MLN Matters® Number: SE1432.

2015 Provider Enrollment Application Fee

Also, the Provider Enrollment Application Fee Amount for Calendar Year 2015 will be $553. This fee will apply to institutional providers that are initially enrolling in the Medicare or Medicaid program or the Children’s Health Insurance Program (CHIP); revalidating their Medicare, Medicaid, or CHIP enrollment; or adding a new Medicare practice location.

This fee is required with any enrollment application submitted on or after January 1, 2015 and on or before December 31, 2015.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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