CMS Pub. 100-08, ch. 10, § 10.3.3.1

Authorization Agreement

(Rev. 13355; Issued: 08-13-25; Effective: 05-05-25; Implementation: 05-05-25)

An EFT agreement (Form CMS-588) authorizes CMS to deposit Medicare payments directly

into a provider/supplier’s bank account.

A. Processing the Form CMS-588 – Specific Situations

When a Form CMS-588 is received, the contractor shall review the form and develop for any

deficiencies or missing information prior to approval. All EFT data shall be entered into

PECOS.

1. Unsolicited Information

If the provider/supplier submits missing/clarifying data or documentation on its own volition

(i.e., without being contacted by the contractor), the contractor shall include this additional

data/documentation in its overall form review.

2. Missing or Incorrect Provider Transaction Access Number (PTAN) or CMS

Certification Number (CCN) on the Form CMS-588

If the PTAN and/or CCN is missing or incorrect but the contractor can ascertain the correct

number (1) via the supporting documents submitted, (2) elsewhere on the form, or (3) via

PECOS, the shared systems, or the provider files, the contractor need not pursue

development. (Note that social security numbers and employer identification numbers do not

fall within this exception.)

3. Missing or Incorrect Social Security Number (SSN) or Employer Identification Number

(EIN) Checkbox on the Form CMS-588

If the Form CMS-588 is received and the checkbox for the SSN or EIN is either not checked

or is incorrectly checked, the contractor may proceed without further development if the

contractor can ascertain the correct option via the supporting documents submitted or

elsewhere on the form.

4. Name on Account

As stated on the Form CMS-588, the account to which EFT payments are made must exclusively

bear the name of the physician or individual practitioner, or the legal business name (LBN) of

the person or entity enrolled with Medicare. Accordingly, the contractor shall accept accounts

that (1) solely list the LBN or (2) list the LBN and the Doing Business As name (so long as the

LBN is listed first).

B. Form CMS-588 Information Specific to Suppliers of Durable Medical Equipment,

Prosthetics, Orthotics, and Supplies

For Form CMS-855S enrollments, CMS only requires the Form CMS-588 with initial

enrollment applications.

C. Form CMS-588 Signature Requirements

For paper applications, handwritten (wet) signatures in ink and digital/electronic signatures

(digital or electronic signatures such as those created by digital signature options created in

software, such as Adobe) are acceptable. For web applications, the supplier can sign it

electronically or upload the signature and then submit the application. The contractor shall

contact its PEOG BFL for questions regarding electronic signatures.

D. Verification

Providers and suppliers may submit a Form CMS-588 via paper or through PECOS. In either

case, the contractor shall ensure that:

(i) All EFT arrangements comply with CMS Pub. 100-04, chapter 1, section 30.2.5.

(ii) The information submitted on the Form CMS-588 is complete and accurate. (Except as

otherwise stated in this chapter or another CMS directive, the contractor shall develop for any

missing information.)

(iii) The provider/supplier submitted (1) a voided check or (2) a letter from the bank

verifying the account information.

(iv) The routing number and account number matches what was provided on the Form CMS-

588.

(v) The signature is valid.

(vi) The contractor shall forgo development if the “Part I: Reason for Submission (Individual

vs. Group)” section is left blank or an incorrect option is selected but the contractor can make

the correct determination based on the provider/supplier’s existing file or additional

information submitted with the application.

E. Miscellaneous EFT Policies

1. Banking Institutions

All payments must be made to a banking institution. EFT payments to non-banking

institutions (e.g., brokerage houses, mutual fund families) are not permitted.

If the provider/supplier’s bank of choice does not or will not participate in the

provider/supplier’s proposed EFT arrangement, the provider/supplier must select another

financial institution.

2. Sent to the Wrong Unit

If a provider/supplier submits an EFT change request to the contractor but not to the latter’s

enrollment unit, the recipient unit shall forward it to the enrollment staff, which shall then

process the change. The enrollment unit is responsible for processing EFT changes. As such,

while it may send the original EFT form back to the recipient unit, the enrollment unit shall

keep a copy of the EFT form and append it to the provider/supplier’s Form CMS-855 in the

file.

3. Bankruptcies and Garnishments

If the contractor receives a copy of a court order to send payments to a party other than the

provider/supplier, it shall contact the applicable SOG Location’s Office of General Counsel.

4. Closure of Bank Account

If a provider/supplier has closed its bank/EFT account but will remain enrolled in Medicare,

the contractor shall place the provider/supplier on payment withhold until a Form CMS-588

(and Form CMS-855, if applicable) is submitted and approved by the contractor. If such an

agreement is not submitted within 90 days after the contractor learned that the account was

closed, the contractor shall commence deactivation procedures in accordance with the

instructions in this chapter. The basis for deactivation would be § 424.540(a)(2) due to the

provider/supplier’s failure to submit updated EFT information within 90 days of the change.

5. Reassignments

If a physician or non-physician practitioner is reassigning all benefits to another supplier and

the latter is not currently on EFT, neither the practitioner nor the reassignee needs to submit a

Form CMS-588. This is because (1) the practitioner is not receiving payment directly, and

(2) accepting a reassignment does not qualify as a change of information request. If,

however, the group later submits a change of information request and is not on EFT, it must

submit a Form CMS-588.

6. Final Payments

If a non-certified supplier (e.g., physician; ambulance supplier) voluntarily withdraws from

Medicare and needs to obtain its final payments, the contractor shall send such payments to

the supplier's EFT account of record. If the account is defunct, the contractor can send

payments to the supplier’s “special payments” address or, if none is on file, to any of the

supplier’s practice locations on record. If neither the EFT account nor the aforementioned

addresses are available, the supplier shall submit a Form CMS-855 or Form CMS-588

request identifying where it wants payments to be sent.

7. Chain Organizations

Per CMS Pub. 100-04, chapter 1, section 30.2, a chain organization may have payments to its

providers be sent to the chain home office. However, and except as otherwise permitted for

PECOS applications under PECOS 2.0, any mass EFT changes (involving large numbers of

chain providers) must be submitted and processed in the same fashion as any other change in

EFT data. For instance, if a chain has 100 providers and each wants to change its EFT

account to that of the chain home office, 100 separate Form CMS-588s must be submitted

(again, unless PECOS 2.0 permits a consolidated submission for PECOS applications). If

any of the chain providers have never completed a Form CMS-855 before, they must do so at

that time.

8. Consolidation of EFT Accounts

The contractor shall follow the instructions in section 10.6.23 of this chapter regarding the

consolidation of a provider’s or supplier’s EFT accounts. These instructions take precedence

over any contrary guidance in this chapter.

9. Address on EFT Form

Notwithstanding any guidance to the contrary in this chapter or on the Form CMS-588, the

account holder’s street address (including city, state, and zip) on the EFT form can be the

provider’s or supplier’s:

• Practice location address (if the provider or supplier has multiple practice locations, any

location address may be used);

• Correspondence address;

• Special payment address; or

• Chain home office (CHO) address (though only for providers reporting a CHO on the

Form CMS-855A).