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US · guidance

CMS Pub. 100-06, ch. 6, § 430.5

Completing Lines Twelve Through Seventeen - Reason for Denial

activein force · 2026-08-25 – presentas-observed

B3-13430.5

Line 12 - Sanctioned From Medicare - The number of applications denied because the applicant

is currently excluded/sanctioned from Medicare.

Line 13 - Debarred/Excluded by Other Federal Agency - The number of applications denied

because the applicant had been debarred, suspended, or excluded by any other Federal agency.

Line 14 - Not Professionally Licensed - The number of applications denied because the applicant

was not professionally licensed.

Line 15 - Business Address Invalid - The number of applications denied because the applicant

had an invalid business address.

Line 16 - Business Location Not Licensed - The number of applications denied because the

applicant’s business location was not properly licensed.

Line 17 - CMS Requirements Not Met - The number of applications denied because the

applicant did not meet all CMS requirements.

History

(Rev. 6, 08-30-02)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
0fd5237f0af1afd0acfaf3e6e8a70bfe7d40c006f30a037893aa7f8698a60eea
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