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This version of the form is not currently in use and is provided for reference only. Download this version of
Form CMS-855S
for the current year.
Form CMS-855S Medicare Enrollment Application - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (Dmepos) Suppliers
What Is Form CMS-855S?
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 January 1, 2022 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-855S?
A: Form CMS-855S is the Medicare Enrollment Application for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers.
Q: Who needs to complete Form CMS-855S?
A: DMEPOS suppliers need to complete Form CMS-855S to enroll or revalidate their Medicare billing privileges.
Q: What is DMEPOS?
A: DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. It refers to medical equipment and supplies that are used for medical purposes at home, such as wheelchairs, orthotics, prosthetics, and oxygen equipment.
Q: What information is required to complete Form CMS-855S?
A: To complete Form CMS-855S, you will need to provide information about your business, such as its name, address, and type of ownership, as well as information about the services you provide and your suppliers.
Q: How can I submit Form CMS-855S?
A: Form CMS-855S can be submitted electronically through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), or by mail to the appropriate Medicare Administrative Contractor (MAC).
Q: How long does it take to process Form CMS-855S?
A: The processing time for Form CMS-855S varies, but it can take several weeks to several months. It is recommended to submit the application well in advance to ensure timely processing.
Q: Are there any fees associated with Form CMS-855S?
A: Yes, there is an application fee for Form CMS-855S. The fee amount may vary and should be paid electronically through the Medicare Administrative Contractor (MAC) or through the CMS-855S application process.
Q: What happens after submitting Form CMS-855S?
A: After submitting Form CMS-855S, your application will be reviewed by the Medicare Administrative Contractor (MAC). They may request additional information or documentation. Once approved, you will receive a Medicare supplier number.
Form Details:
- Released on January 1, 2022;
- 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-855S 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-855S Medicare Enrollment Application - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (Dmepos) Suppliers
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