Form CMS-8550 Processing Guide

A new supplemental guide has been added to the Medicare Program Integrity Manual to assist those involved in preparing and submitting form CMS-8550.

Form CMS-8550 is a Medicare enrollment application for certain eligible ordering and certifying professionals along with other eligible professionals who order or certify items or services for Medicare beneficiaries.

Form CMS-8550 Requirements

Many doctors and other eligible professionals enroll with Medicare so they may be reimbursed for those covered services that they provide to Medicare beneficiaries.

However, the Affordable Care Act requires that certain physicians and eligible professionals who order or certify items or services for Medicare beneficiaries must also enroll with Medicare, even though they are not requesting reimbursement for Medicare services.

Examples of those who may enroll in Medicare only for ordering and certifying include but are not limited to:

• Doctors of Medicine or Osteopathy
• Doctors of Dental Medicine or Dental Surgery
• Doctors of Podiatric Medicine
• Doctors of Optometry
• Physicians Assistants
• Nurse Practitioners
• Clinical Social Workers
• Clinical Psychologists

You can find a complete list of those who should complete and submit this form here along with instructions for completing the form.

Those who choose to enroll for the sole purpose of ordering or certifying items or services for Medicare beneficiaries may complete the CMS-8550 form using paper, or may use the PECOS process.

Read the Change Request for Medicare Administrative Contractors that adds the form CMS-8550 processing guide to the Medicare Program Integrity Manual.

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.