If you don’t use PECOS, use the revised CMS-855I (Medicare Enrollment Application – Physicians and Non-Physician Practitioners) to enroll or update your information. Medicare Administrative Contractors will accept current and revised versions of the form through October 31, 2023. Starting November 1, 2023, you must use the revised form.
Form updates:
Combines the CMS-855I and CMS-855R paper applications and discontinues the CMS-855R
Removes physician assistant employer arrangements
Recognizes physicians and non-physicians who provide acupuncture services
Identifies compact licenses
Adds new physician specialties
Expands practice location types to include telehealth