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US · guidance

CMS Pub. 100-08, ch. 10, § 10.3.1.1.7

Section 8 (Billing Agency Information) - Form CMS-855A

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

(Regarding the Billing Agency Information section of the Form CMS-855A, see section 10.6.8

of this chapter. Except as otherwise stated, the PECOS policies in section 10.3 supersede those

in section 10.6.8.)

If the chain organization listed in Section 7 of the Form CMS-855A also serves as the provider’s

billing agent, the chain must be listed in Section 8 as well.

If the telephone number is blank, the contractor may verify it with the provider via telephone, the

PCV, e-mail, or fax.

If all of the Billing Agency Information section is blank (including the check box), no additional

development is necessary.

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
057133f74f73dd8e141ac980b440c866ff13383fa90cd1c6eddcdaf19bc0a8c0
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