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Form CMS-855I Medicare Enrollment Application - Physicians and Non-physician Practitioners

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  7. Form CMS-855I Medicare Enrollment Application - Physicians and Non-physician Practitioners

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Form CMS-855I Medicare Enrollment Application - Physicians and Non-physician Practitioners

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What Is Form CMS-855I?

This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on December 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form CMS-855I?
A: Form CMS-855I is the Medicare Enrollment Application for Physicians and Non-physician Practitioners.

Q: Who should use Form CMS-855I?
A: Physicians and Non-physician Practitioners who want to enroll in or make changes to their Medicare participation.

Q: What information is required on Form CMS-855I?
A: The form requires information such as personal details, practice information, licensure and certification details, billing information, and Medicare billing privileges.

Q: What should I do after completing Form CMS-855I?
A: After completing Form CMS-855I, you should submit the form to your Medicare Administrative Contractor (MAC) along with any required supporting documentation.

Q: How long does it take to process Form CMS-855I?
A: The processing time for Form CMS-855I can vary, but it generally takes around 60 days for the application to be reviewed and processed.

Q: What happens after my Form CMS-855I is approved?
A: Once your Form CMS-855I is approved, you will receive a Medicare provider number, which allows you to bill Medicare for your services.

Q: Can I make changes to my Form CMS-855I after it has been submitted?
A: Yes, you can make changes to your Form CMS-855I after it has been submitted by submitting a new application or using the Provider Enrollment, Chain, and Ownership System (PECOS) to update your information.

Q: Are there any fees associated with submitting Form CMS-855I?
A: No, there are no fees associated with submitting Form CMS-855I.

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Form Details:

  • Released on December 1, 2018;
  • The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CMS-855I by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.

Download Form CMS-855I Medicare Enrollment Application - Physicians and Non-physician Practitioners

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