Glossary
CMS-855B
Short answer
The CMS-855B is the Medicare enrollment application that clinics, group practices and other Part B suppliers, such as independent laboratories and ambulance suppliers, use to enroll, revalidate, report changes and accept reassignments, on paper or through PECOS.
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Last reviewed by the Remitwright billing team. Editorial policy
Also written as855BForm CMS-855BCMS 855B
The CMS-855B enrolls the organization rather than the clinician. Clinics, group practices and other suppliers complete it to enroll in Medicare and receive a Medicare billing number, on paper or through Internet-based PECOS. The supplier side is wider than medical groups: the form names independent laboratories and portable x-ray suppliers, and it carries attachments that ambulance suppliers, independent diagnostic testing facilities and opioid treatment programs must complete1.
Specific events call for a new 855B. A group files one when it enrolls with a MAC for the first time under a tax identification number, when it gets a new tax ID, when it opens a location in another MAC’s territory, when it reactivates a billing number, and when its MAC asks it to revalidate. The form warns against sending a revalidation before the MAC has made contact. Changes such as an added or moved practice location are reported within the time frames set by 42 CFR 424.516, and where an application fee applies the supplier pays it before submitting1.
Identity has to line up first. The 855B calls for a Type 2 NPI, and the legal business name and TIN must be the ones used to obtain it, since they have to match exactly in PECOS and NPPES; a sole proprietor reports the individual Type 1 NPI instead1. The group’s half of a reassignment lives on this form too. Accepting a new reassignment takes signatures from both the group’s delegated or authorized official and the practitioner, while a change or termination can be signed by either one1. No reassignment takes effect until both the group and the practitioner are enrolled, or enrolling together through the 855B and the CMS-855I2.
CMS-855B in practice
Two physicians form a professional corporation with its own tax ID. The corporation obtains a Type 2 NPI and files a CMS-855B to enroll with its MAC, and each physician files a CMS-855I reassigning benefits to the corporation at the same time, so claims for their visits can be paid to the new group. Hypothetical example.
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