CMS-855I Medicare Enrollment Application: Physicians and Non-Physician Practitioners 2025

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The CMS-855I is a Medicare enrollment application for physicians and non-physician practitioners, detailing the process for enrolling in the Medicare program, updating enrollment information, and reassigning benefits. It outlines who should submit the application, necessary documentation, and instructions for completion. The form emphasizes the importance of accurate information to avoid delays and includes sections on personal identifying information, practice locations, managing employees, and legal actions. Additionally, it highlights penalties for providing false information and requires a certification statement from the applicant.

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Who is the CMS form 855I the enrollment application 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 difference between Plan A and B?

Parts A and B make up Original Medicare. Part A covers many costs of inpatient care. Part B primarily covers the costs of outpatient treatment and preventive care, such as doctor visits, medical equipment, and some prescriptions.

What is Medicare 855B?

Clinics, group practices, and other suppliers can apply for enrollment in the Medicare program or make a change in their enrollment information using either: The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or The paper CMS-855B enrollment application.

Do physicians have to enroll in Medicare?

Physicians are not required to participate in Medicare, though the vast majority of them choose to do so.

What does Medicare consider a non-physician practitioner?

Services rendered by Non-Physician Medical Practitioners (NMPs) are covered by Medi-Cal. NMPs consist of Physician Assistants (PAs), Nurse Practitioners (NPs) and Certified Nurse Midwives (CNMs).

medicare cms 855

CMS-855R CMS-855B cms-855i form pdf CMS 855i online application Medicare Provider Enrollment application PDF CMS-855A cms-855i instructions CMS-460

What is the difference between Medicare 855B and 855I?

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 difference between CMS 855B and 855I?

CMS-855B: For group (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) CMS-855R: Individuals reassigning (entire application).