US · guidance
CMS Pub. 100-08, ch. 10, § 10.3.1.1
Form CMS-855A – Medicare Enrollment Application for
Institutional Providers
(Rev. 11839; Issued: 02-09-23; Effective: 04-21-23; Implementation: 06-19-23)
Institutional providers (e.g., hospitals) that will furnish Medicare Part A services to beneficiaries
must complete the Form CMS-855A. For purposes of this section 10.3.1.1 et seq. (and except as
otherwise stated), the term “provider” includes certified suppliers that must complete the Form
CMS-855B.
History
(Rev. 11839; Issued: 02-09-23; Effective: 04-21-23; Implementation: 06-19-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
6f89f819e849ea97a821e5098c3da0b8a1557636ef5f565b3fe62316e44efe0b
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