Palmetto GBA - Ohio Part B Carrier - Provider Enrollment

Palmetto GBA

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Provider Enrollment

Provider Enrollment Resources:

Enroll, change your Medicare information, and add or delete group members or locations online: https://pecos.cms.hhs.gov (print, sign and date the two-page Certification Statement and mail the Certification Statement and all supporting paper documentation to Palmetto GBA within seven days of electronic submission)
Access CMS-855 forms (then print, sign and mail to Palmetto GBA)
Palmetto GBA mailing addresses
Access the status of your CMS-855 application
Guidance on which form to complete
Contact the Provider Enrollment Support Line at (866) 308-5439 for additional assistance

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Provider Enrollment

Show details for 855 Application

855 Application

Show details for General

General

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IDTF

Independent Diagnostic Testing Facilities (IDTFs): Revised Instructions for Compliance Standards

02/07/2008

IDTF Diagnostic Tests With Level of Supervision and Technician Qualification Requirements Table

06/27/2007

IDTF Diagnostic Tests: CMS-855 Application

06/27/2007

IDTF Diagnostic Tests: Professional License Requirements

06/27/2007

IDTF Services: CPT Codes 0016T - 0170T

06/27/2007

IDTF Services: CPT Codes 10021 - 19499

06/27/2007

IDTF Services: CPT Codes 20100 - 29999

06/27/2007

IDTF Services: CPT Codes 30000 - 39599

06/27/2007

IDTF Services: CPT Codes 40490 - 49999

06/27/2007

IDTF Services: CPT Codes 50010 - 59899

06/27/2007

IDTF Services: CPT Codes 60000 - 69990

06/27/2007

IDTF Services: CPT Codes 70010 - 79999

06/27/2007

IDTF Services: CPT Codes 90281 - 99602

06/27/2007

IDTF Services: HCPCS Codes A0021 - A9999

06/27/2007

IDTF Services: HCPCS Codes G0008 - G9130

06/27/2007

IDTF Services: HCPCS Codes J0120 - J9999

06/27/2007

IDTF Services: HCPCS Codes M0064 - M0301

06/27/2007

IDTF Services: HCPCS Codes Q0035 - Q9964

06/27/2007

Show details for Opt Out

Opt Out

last updated on 11/20/2009

CMS