Physicians & Non-Physician Practitioners: Revised Medicare Enrollment Application Required November 1

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

Visit Medicare Enrollment for Providers & Suppliers for more information, including an CMS-855I instructional guide. To enroll and update your information more quickly and easily, use PECOS.

NGSMedicare Weekly News, 9/7/23

Michele Krpata, BSW, CPC, CPMA

Compliance Officer, Quality Reporting Analyst

For more information and application instructions for the Phase 3 General Distribution of Provider Relief Fund go to