Revised 855S Enrollment Application

After October 31, 2011, DMEPOS suppliers will no longer be permitted to use the 07/09 version of the CMS-855S application and will be required to utilize the updated 07/11 version. The 07/11 version is available and may be used for submissions now. The newest version of the application has been updated to capture additional information pertinent to processing by the National Supplier Clearinghouse. If a supplier submits the 07/09 version after October 31, 2011, the application will not be processed and it will be returned to the supplier. Also, keep in mind, as of March 25, 2011, DMEPOS suppliers are subject to an enrollment fee to obtain and maintain Medicare billing privileges. Suppliers are required to pay this fee when submitting enrollment information for initial applications, reactivations, revalidations or changes of ownership resulting in a change of Tax ID. The fee for calendar year 2011 is $505.Should you have any questions, please contact:Todd Selby at 317.977.1440 or tselby@wp.hallrender.com; Kendra Conover at 317.977.1456 or kconover@wp.hallrender.com or your regular Hall Render attorney.