Who needs the CMS Form 885B?
The 885B form is the Centers for Medicare and Medicaid Services (CMS) form also known as the Medicare Enrollment Application for Clinics, Group Practices, and Certain Other Suppliers. There is a list of suppliers that are supposed to file the CMS-885B in order to commence the process of enrollment. These suppliers are:
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Ambulance Service Supplier
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Ambulatory Surgical Center
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Clinic/Group Practice
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Independent Clinical Laboratory
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Independent Diagnostic Testing Facility
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Intensive Cardiac Rehabilitation Supplier
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Mammography Center
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Mass Immunization
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Part B Drug Vendor
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Portable X-ray Supplier
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Radiation Therapy Center
What is the CMS Form 885B for?
The CMS Form 885B has been specifically designed for specific types of suppliers to enable them to apply for enrollment in the Medicare program or to update or amend their previously indicated information.
Is the Medicare Enrollment Application CMS-885B accompanied by any other forms?
The Enrollment Application requires a list of supporting forms and may not be filed as a single document. All the mandatory attachments to the CMS-885B form are clearly defined on page 36 of the fillable application form itself.
However, here are the two commonly attached documents:
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Form CMS-588 (Electronic Funds Transfer Authorization Agreement)
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CMS Form 460 (Medicare Participating Physician or Supplier Agreement)
How to fill out the CMS-885B Form?
The voluminous 49-page form contains 17 sections and 2 attachments to fill out. Broadly put, the form requests basic identifying information, practice location, ownership interest, billing agency information, certification statement, etc.
Where do I send the completed CMS-885B Application Form?
Having completed the form and all the required attachments, the applicant should deliver them to the Medicare fee-for-service contractor operating in the relevant geographic location.