Cms 855i 2025

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The document is the Medicare Enrollment Application (CMS-855I) for physicians and non-physician practitioners. It outlines the process for enrolling in the Medicare program, including eligibility criteria, required documentation, and instructions for completing and submitting the application. The form also details penalties for providing false information and includes sections for personal information, practice location, managing control, and billing agency information.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (55 Votes)
2011	4.4 Satisfied (236 Votes)
2006	4 Satisfied (38 Votes)

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What is the difference between 855I and 855B?

CMS-855B: For organization (all applicable sections). CMS-855I: For reassigning individuals who are new to the Medicare program, or not PECOS enrolled (sections 1, 2, 3, 4B, 13, and 15). CMS-855I: For employed physician assistants (sections 1, 2, 3, 13, and 15).

What is the CMS-855I used for?

All physicians, as well as all eligible professionals as defined in section 1848(k)(3)(B) of the Social Security Act must complete this application to enroll in the Medicare program and receive a Medicare billing number.

What is the purpose of the CMS?

CMS is the federal agency that provides health coverage to more than 160 million through Medicare, Medicaid, the Childrens Health Insurance Program, and the Health Insurance Marketplace. CMS works in partnership with the entire health care community to improve quality, equity and outcomes in the health care system.

What is CMS 855R individual reassignment of medicare benefits?

The CMS-855R application is used by individual physicians and non-physician practitioners (hereafter collectively referred to as individual practitioners) who want to reassign their right to receive Medicare payments to another eligible individual or entity (i.e., sole proprietorship/clinic/group practice/other

What is one reason why a provider would complete a CMS 855B form?

What is the 855B? ❖ The CMS form used for the enrollment of Clinic/Group practices and Certain Other Suppliers. This form is also used to submit changes to your enrollment data.