CMS-855
CMS-855I or CMS-855B — and why the 855R no longer exists
The CMS-855R was discontinued and merged into the CMS-855I. MACs have returned newly submitted applications on the old form since 1 November 2023.
The 855R is gone, and a lot of published advice has not caught up
CMS discontinued the CMS-855R for reporting reassignment of Medicare benefits and merged it into the CMS-855I. MACs began accepting the revised CMS-855I (05/23) on 1 September 2023 and, after 1 November 2023, return newly submitted applications filed on the old CMS-855I (12/21) or CMS-855R (01/20).
Organizations and groups accepting, terminating or changing a reassignment also submit the CMS-855I now.
CMS’s current enrollment applications page lists the CMS-855A, 855B, 855I, 855O, 855S and CMS-20134. The 855R is not among them.
Source: CMS consolidated CMS-855I bulletin (PDF) · CMS — Medicare enrollment applications
Which form for which situation
CMS-855I: physicians and non-physician practitioners. This is also now the form for reassignment.
CMS-855B: clinics, group practices and certain other suppliers.
Alongside either, two forms are routine: the CMS-588 EFT Authorization Agreement, so Medicare can pay you electronically, and the CMS-460 Medicare Participating Physician or Supplier Agreement.
CMS notes that applications submitted through PECOS tend to process faster than paper.
PECOS 2.0
CMS has deployed a modernised PECOS. Data from the current system transfers across, in-progress applications can be continued from where you left off, your MAC does not change, and the login is still the Identity & Access username and password.
CMS lists pre-populated applications, one application updating multiple enrollments, real-time status tracking and a simplified revalidation process among the changes.
Source: CMS PECOS 2.0 FAQs (PDF)
Questions
Is the CMS-855R still used?
No. CMS merged reassignment reporting into the CMS-855I. MACs accepted the revised CMS-855I (05/23) from 1 September 2023 and returned newly submitted applications on the CMS-855R (01/20) after 1 November 2023.
Do I file an 855I or an 855B for a new group practice?
Both, for different things. The CMS-855B enrols the clinic or group practice as a supplier. Each physician or NPP files a CMS-855I, which is also where the reassignment of benefits to the group is now reported.
What else goes in with the application?
Commonly the CMS-588 EFT Authorization Agreement and the CMS-460 participating physician agreement. CMS also states a MAC will not fully process an application missing a signature, the fee where one applies, or supporting documentation.
A research summary, not legal or enrollment advice. Every rule above links to the regulation or the CMS document it came from so you can check it rather than trust it.
The rest of the cluster
If this is work somebody on your team is doing at four in the afternoon, it can be a seat.
Next step
A lapsed enrollment stops every claim behind it
A credentialing seat works enrollments, revalidations and CAQH attestation, so none of these dates arrives unannounced.
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