US · guidance
CMS Pub. 100-08, ch. 10, § 10.3.1.2
Form CMS-855B –Medicare Enrollment Application for Clinics,
Group Practices, and Certain Other Suppliers
(Rev. 11839; Issued: 02-09-23; Effective: 04-21-23; Implementation: 06-19-23)
This application should be completed by supplier organizations (e.g., ambulance companies) that
will bill Medicare for Part B services furnished to Medicare beneficiaries. It is not used to enroll
individuals.
The policies in this section 10.3.1.2 et seq. apply exclusively to the Form CMS-855B (except as
otherwise noted).
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
92da2acece6f0e9e86022375cc9e3d9e64d7f5e4e0c02e1ad8d6f38911ed38a6
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