Medicare Provider Enrollment Compliance Conference

MPECC

CMS Issues Notice of Revised CMS-855R

On February 6, 2019, CMS issued a notification that the paper Form CMS-855R version will be changing. The current Form CMS-855R, version 4/16, which is used to enroll and deactivate practitioners from the Medicare program, is one of the most common Medicare enrollment forms utilized. Changes to the form version include the addition of a secondary practice location, which is used for physician compare reporting purposes, and an additional reason for submission called “Change of Reassignment Information.” The new paper version of the form is available on the CMS website and will be required for use as of May 1, 2020, when mailing to the Medicare Administrative Contractors. Please note reassignment submissions through electronic-based PECOS will always be on the latest version of the form. 

Be sure you are prepared for this and other major changes impacting Medicare provider enrollment.  We will be walking through the completion of each of the CMS-855 enrollment forms and the compliance risks associated with it, along with much more, at the Medicare Provider Enrollment Compliance Conference, April 27-30, 2020 at the Phoenix Convention Center.  Visit www.medicareproviderenrollment.com for more information and to register.

2 thoughts on “CMS Issues Notice of Revised CMS-855R

  1. bonnie lavoie says:

    Do we still need to do an 855B if we complete the 855R

    1. Gretchin Heckenlively says:

      Hi Bonne,
      A Form CMS-855B must be established or in the process of being established in order for a practitioner to reassign (Form CMS-855R) his/her rights to bill to the group. If the group is already established and the new practitioner’s reassignment does not change any of the information already reported on the Form CMS-855B, then a Form CMS-855B does not need to be completed in addition to the Form CMS-855R. However, if the new practitioner will perform services at new practice locations not currently reported on the Form CMS-855B and the group will be billing for the professional services provided at these locations, for instance, then an update to the Form CMS-855B would need to be made. You will need to take into consideration services performed across state lines, in different pay localities and/or different reasonable charge localities, etc., if applicable, and the Medicare Administrative Contractor responsible for the service locations to determine if there are additional reporting requirements.

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