CMS Pub. 100-08, ch. 10, § 10.6.7.3

Numbers (TINs)

(Rev. 10868; Issued: 07-14-21; Effective: 08-13-21; Implementation: 08-13-21)

A. General Disclosure Requirement

Consistent with sections 1124 and 1124A of the Social Security Act, the provider must report

the TINs (employer identification numbers (EIN) or social security numbers (SSN)) of all

entities and individuals listed in the Organizational and Individual Ownership and/or

Managing Control sections of the Form CMS-855 and Form CMS-20134. If the provider fails

to do so, the contractor shall follow normal development procedures for requesting the TIN.

When documentation of the provider’s TIN and/or legal business name (LBN) is required,

the contractor may accept a CP-575, a federal tax department ticket, or any other pre-printed

document from the IRS that identifies the TIN and/or LBN.

Except as otherwise stated in this chapter, if a provider is changing its TIN the transaction

shall be treated as a brand new enrollment as opposed to a change of information; the

provider must complete a full Form CMS-855 or CMS-20134 and a new enrollment record

must be created in PECOS.

B. TIN Disclosure Requirements for Individuals Who Do Not Have (and Are Ineligible

to Obtain) an Employer Identification Number or an SSN from the Social Security

Administration (SSA)

In following the normal development procedures for requesting an unreported but required TIN,

the contractor shall undertake the applicable steps described in section 10.6.7.3(B)(1) and (2)

below if it determines that the TIN was not furnished because the entity or person in question is

not eligible to obtain a SSN from the SSA.

1. Contacting Provider

The contractor shall ask the provider (via any means) whether the person or entity can obtain a

TIN or, in the case of individuals, an individual taxpayer identification number (ITIN). (Only one

inquiry is needed.)

a. If the provider fails to respond to the contractor’s inquiry within 30 days, the contractor shall

follow the instructions in section 10.6.7.3(B)(2) below.

b. If the provider states that the person or entity is able to obtain a TIN or ITIN, the contractor

shall send an e-mail, fax, or letter to the provider stating that: (i) the person or entity must

obtain a TIN/ITIN; and (ii) the provider must furnish the TIN/ITIN on the Form CMS-

855/20134 with a newly-signed certification statement within 90 days of the contractor’s

request.

c. If the provider states that the person or entity cannot obtain a TIN or ITIN, the contractor shall

send an e-mail, fax, or letter to the provider stating that: (i) the provider must submit written

documentation to the contractor explaining why the person or entity cannot legally obtain a

TIN or ITIN; and (ii) the explanation – which can be in any written format and may be

submitted electronically or via fax – must be submitted within 30 days of the contractor’s

request.

2. Provider Response

If the provider timely submits the explanation in section 10.6.7.3(B)(1)(c) above, the contractor

shall forward the explanation to its CMS Provider Enrollment & Oversight Group Business

Function Lead (PEOG BFL); PEOG will notify the contractor as to how the application should be

handled. If the provider fails to timely respond to the contractor’s inquiry in either section

10.6.7.3(B)(1)(a) or (c), the contractor shall – unless another CMS instruction directs otherwise -

reject the application consistent with the procedures identified in this chapter.

3. Clock Stoppages

When the contractor is required under section 10.6.7.3(B)(2) to contact PEOG, the

application processing time clock is stopped. It resumes on the date on which the contractor

receives PEOG’s decision, instruction, or final guidance, as applicable. Interim

communication between the contractor and PEOG during such “waiting periods” (e.g.,

PEOG request for additional information from the contractor) does not restart the clock.

Optional communications---that is, communications with PEOG that are not specifically

directed under section 10.6.7.3(B)(2)---do not stop the processing clock.