Form CMS-855I / CMS-855B
Medicare Enrollment Application for Providers
Application used by individual practitioners (CMS-855I) or organizations (CMS-855B) to enroll as Medicare providers and establish billing privileges.
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About Form CMS-855I / CMS-855B — Medicare Enrollment Application for Providers
Form CMS-855I is used by individual healthcare practitioners — including physicians, nurse practitioners, and physician assistants — to enroll in the Medicare program and establish billing privileges. Form CMS-855B is the equivalent for clinics, group practices, and other healthcare organizations. Providers must be enrolled and approved before submitting claims to Medicare for reimbursement. Applications are submitted through PECOS (Provider Enrollment, Chain, and Ownership System) online or via paper form to the applicable Medicare Administrative Contractor (MAC).
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Form CMS-855I / CMS-855B is an official form published by CMS. Official source
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