Get Cms-855b 2021-2025

The CMS-855B is an essential application for clinics, group practices, and other suppliers seeking to enroll in the Medicare program. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the CMS-855B online.

1. Click ‘Get Form’ button to obtain the CMS-855B application and open it in the editor.
2. In Section 1, select the reason for submitting the application, such as enrolling for the first time or making changes to existing enrollment. Ensure all applicable subsections are completed.
3. Complete Section 2 with your identifying information. Enter your legal business name, Tax Identification Number (TIN), and National Provider Identifier (NPI). Ensure all identifiers match the documents provided.
4. Fill out Section 3 regarding any final adverse legal actions. Document any relevant legal history as required to comply with reporting standards.
5. In Section 4, provide practice location information. List all addresses where services are rendered, ensuring they conform to postal standards.
6. Complete any attachments if necessary, such as Attachment 1 for ambulance service suppliers or Attachment 2 for independent diagnostic testing facilities.
7. Review all sections for completeness and accuracy, ensuring documentation and required signatures are included.
8. Save your progress, and when finished, download or print the completed application for record-keeping.
9. Submit the finalized CMS-855B with all supporting documents to your designated Medicare Administrative Contractor (MAC) as per submission guidelines.

Start completing your CMS-855B application online today to expedite your Medicare enrollment.