How to Complete and Submit the CMS-855B Medicare Enrollment Application

The CMS 855B Medicare enrollment application is the form clinics, group practices, and certain Part B suppliers file to obtain Medicare billing privileges. You can submit it electronically through the Provider Enrollment, Chain, and Ownership System (PECOS) or mail a paper copy to your regional Medicare Administrative Contractor (MAC). The 2026 application fee is $750, though many supplier types owe nothing. Without an approved 855B on file, your organization cannot bill Medicare for services provided to beneficiaries.1Centers for Medicare & Medicaid Services. CMS Form 855B Medicare Enrollment Application

Who Should File the 855B

The 855B is for organizations and groups billing Medicare Part B. The form’s instructions list group practices, clinics, independent clinical laboratories, and portable X-ray suppliers as common filers.1Centers for Medicare & Medicaid Services. CMS Form 855B Medicare Enrollment Application Ambulance service suppliers and mass immunization entities that bill as a group also use this form.2Centers for Medicare & Medicaid Services. Roster Billing Physical therapy and occupational therapy practices billing under a group structure belong here as well.

If you’re an individual practitioner, you file the 855I instead. Hospitals, skilled nursing facilities, and other institutional providers use the 855A. Sole proprietors are the odd case: CMS treats them as “Type 1” providers for NPI purposes, so a sole proprietor reports their individual Type 1 NPI on the 855B rather than an organizational Type 2 NPI.1Centers for Medicare & Medicaid Services. CMS Form 855B Medicare Enrollment Application

Documents to Gather Before You Start

Missing any of these will stall your filing or get it returned.

  • A Type 2 National Provider Identifier for the organization from NPPES. The legal business name and TIN on the NPI record must match exactly what appears on the 855B.1Centers for Medicare & Medicaid Services. CMS Form 855B Medicare Enrollment Application
  • Your Employer Identification Number and an IRS confirmation of it: either the original CP-575 notice or a 147C letter. This is one of the documents applicants most often forget.
  • State business license and any specialty certifications. Independent laboratories need a Clinical Laboratory Improvement Amendments (CLIA) certificate. Ambulance services need vehicle permits and staffing credentials.
  • Ownership information: Social Security numbers, dates of birth, and exact ownership percentages for every individual or entity with a five-percent or greater interest, plus partners, board members, managing employees, and parent companies.
  • Name, SSN, date of birth, and contact information for at least one Authorized Official with legal authority to bind the organization to Medicare’s rules.

Filling Out the Sections That Cause the Most Trouble

The 855B runs long, but the friction concentrates in a handful of sections.

Identifying Information and Practice Locations

Section 2 asks for your legal business name, TIN, NPI, and organizational type: corporation, partnership, LLC, and so on. Name mismatches are the single biggest source of rejections here. If the name on your IRS records doesn’t match your NPI record letter-for-letter, expect the application to come back. Section 4 collects every physical address where you furnish services. Each practice location needs its own entry, including phone number, hours of operation, and whether it’s your primary location. CMS inspectors verify these addresses, so listing a mailing-only address or a co-working space used solely for receiving mail will trigger a denial.3Centers for Medicare & Medicaid Services. Provider Enrollment Site Visits

Ownership and Managing Control

Section 6 is where most applicants slow down. Disclose every individual or entity with a five-percent or greater ownership stake, along with managing employees, officers, and directors who exercise operational control. For each person, provide SSN, date of birth, and exact ownership percentage. If another company owns your entity, disclose the parent’s details and tax information too. CMS runs every name through federal exclusion databases, and a single excluded person on the list will sink the whole application.4eCFR. 42 CFR 424.510 – Requirements for Enrolling in the Medicare Program

Authorized and Delegated Officials

Every 855B must name at least one Authorized Official. That’s an appointed officer such as a CEO, CFO, general partner, chairman of the board, or direct owner with legal authority to enroll the organization in Medicare and commit it to program rules. This person signs the certification statement and takes legal responsibility for the accuracy of the whole application. You can also designate Delegated Officials to handle routine updates after approval, but a Delegated Official must either have an ownership or control interest or be a W-2 managing employee.5eCFR. 42 CFR 424.502 – Definitions

Adverse Legal Actions

The application asks whether your organization, its owners, or its managing employees have any adverse legal action history. Under 42 CFR 424.502, that includes revocation of Medicare billing privileges, state license suspensions or revocations, accreditation revocations, federal or state felony convictions within the past ten years, and exclusion from any federal or state healthcare program. Failing to disclose a known adverse action is treated as false information and is independent grounds for revocation.6eCFR. 42 CFR 424.535 – Revocation of Enrollment in the Medicare Program

The $750 Application Fee and Who’s Exempt

The Medicare enrollment application fee for 2026 is $750.7Centers for Medicare & Medicaid Services. Medicare Enrollment Application Fee Payment It applies to institutional providers and certain suppliers, including DMEPOS suppliers and opioid treatment programs, when enrolling, revalidating, or adding a new practice location.

Physicians, non-physician practitioners, physician organizations, non-physician practitioner organizations, and Medicare Diabetes Prevention Program suppliers are exempt.8Centers for Medicare & Medicaid Services. Medicare Provider Enrollment A physician group practice, for example, typically owes nothing.

If the fee applies to you but paying it would create a genuine financial hardship, submit a written hardship exception request with your application. Explain the hardship and why it justifies a waiver. CMS has 60 days to approve or deny, and the MAC won’t process your application while that decision is pending. If the exception is denied, you have 30 days to pay before the application is rejected.9eCFR. 42 CFR 424.514 – Application Fee Organizations in a Presidentially-declared disaster area may also qualify for a case-by-case exception.

Submitting Through PECOS or by Paper

The fastest route is filing electronically at pecos.cms.hhs.gov.10Centers for Medicare & Medicaid Services. Manage Your Enrollment PECOS checks for errors in real time and accepts document uploads. Even with an electronic submission, you still have to print, sign, and mail the certification statement. The MAC does not consider your filing complete until it receives the signed original, and the Authorized Official must sign in ink. A stamped or copied signature will get the application returned.

To file on paper, download the current 855B from the CMS forms page and mail the completed application with all supporting documents to your regional MAC.11Centers for Medicare & Medicaid Services. CMS 855B Medicare Enrollment Application CMS publishes jurisdiction maps and a state-by-state listing so you can identify the correct MAC.12Centers for Medicare & Medicaid Services. Who Are the MACs Use ink, not pencil; applications completed in pencil are rejected. Confirm you’re using the current form version, because outdated versions come back without processing.

How Long Approval Takes

Processing time depends on how you filed and whether a site visit is required. CMS sets these target windows for MACs:

  • PECOS, no site visit: 15 calendar days
  • PECOS, site visit required: 50 calendar days
  • Paper, no site visit: 30 calendar days
  • Paper, site visit required: 65 calendar days

These are CMS-mandated targets, not guarantees.13Palmetto GBA. Jurisdiction J Part A – Provider Enrollment Application Processing Time Filing through PECOS roughly halves the wait compared to paper.

If something is missing or unclear, the MAC issues a development request asking for the specific documentation or clarification it needs. You have 30 days from the date of the request to respond, and the processing clock pauses in the meantime.1Centers for Medicare & Medicaid Services. CMS Form 855B Medicare Enrollment Application Miss the 30-day window and the MAC returns the application; you start over from scratch.

Why Applications Get Rejected

Most rejections are preventable clerical errors. The recurring ones:

  • The legal business name on the application doesn’t match IRS or NPPES records. Even an ampersand versus “and” can do it.
  • The certification statement is unsigned, undated, or bears a copied or stamped signature instead of an original.
  • The applicant used a superseded version of the 855B rather than the current revision on the CMS website.
  • The application arrived without the required fee or a hardship exception request when one was owed.
  • The applicant used the wrong form type. An 855B where an 855A was needed, or vice versa, gets returned.
  • Supporting documents are missing: the IRS confirmation letter, the CLIA certificate, or other required attachments.

Each of these sends you back to the starting line, so a careful review before submitting pays for itself.

What Happens During a Site Visit

CMS uses National Site Visit Contractors to conduct unannounced inspections of the practice locations you listed. Inspectors arrive during normal business hours to confirm the address is a real, operating healthcare facility.3Centers for Medicare & Medicaid Services. Provider Enrollment Site Visits They look for specific red flags: a vacant suite with no signage, posted hours with no observed business activity, or an unrelated business at the address. They photograph the location and verify that co-working spaces aren’t being used solely as mail drops.

DMEPOS suppliers face additional scrutiny. Inspectors check for permanent signage showing business name and hours, on-site inventory, and documentation such as licenses, complaint logs, and purchase agreements. If the inspector finds a non-operational location, CMS can deny the application or deactivate existing billing privileges. Refusing to allow a site visit produces the same result.3Centers for Medicare & Medicaid Services. Provider Enrollment Site Visits

After Approval: Keeping Your Enrollment Current

Reporting Changes

Enrollment doesn’t end at approval. Medicare requires you to keep your record current. Changes to ownership, managing control, or authorized officials must be reported within 30 days. Other updates, such as a new practice location, phone number change, or revised business hours, must be reported within 90 days. Some changes, including a change of ownership, need pre-approval before they take effect. Report changes through PECOS or by submitting an updated 855B to your MAC.

If the MAC sends a development request tied to an update and you don’t respond in time, your billing privileges can be deactivated.6eCFR. 42 CFR 424.535 – Revocation of Enrollment in the Medicare Program Deactivation stops your Medicare payments until you file a complete new enrollment application and get re-approved.

Revalidation

Most providers and suppliers revalidate every five years. DMEPOS suppliers revalidate every three. CMS sends a revalidation notice when your cycle comes due. Missing the deadline can result in a payment hold or full deactivation. If you’re deactivated, there’s no shortcut back in; you submit a brand-new enrollment application.14Centers for Medicare & Medicaid Services. Revalidations – Renewing Your Enrollment

If Your Application Is Denied

A denial isn’t necessarily the end. CMS offers two paths forward, and they aren’t mutually exclusive.

If the denial is based on failure to meet enrollment requirements under 42 CFR 424.530(a)(1), you can submit a Corrective Action Plan (CAP) within 35 calendar days of the date on the MAC’s denial letter. The CAP is a written response addressing the specific deficiencies the MAC identified: missing documents, incomplete disclosures, or operational issues.15Centers for Medicare & Medicaid Services. Provider Enrollment Appeals Procedure

For any denial, you can request a formal reconsideration within 65 calendar days of the denial letter. Someone not involved in the original decision reviews it. Your request must identify which findings you disagree with and why, and you should include any additional supporting documentation now, because this is typically your only chance to add evidence during the appeals process.15Centers for Medicare & Medicaid Services. Provider Enrollment Appeals Procedure Miss the 65-day window and CMS treats it as a waiver of all rights to further administrative review.