The Reenrollment and the Revised CMS 855S
On May 1, 2006, the Centers for Medicare and Medicaid Services (CMS) released the revised CMS 855 enrollment forms. Suppliers were instructed to begin using these forms immediately for enrollment purposes.
However, suppliers may notice the reenrollment packages received from the NSC are a combination of the previous (11/2001) and revised versions of the CMS 855S. Please note this is not an error. CMS has instructed the NSC to continue to use the previous version of the CMS 855S for reenrollment purposes with the exception of sections 3, 14 and 15, which are from the revised form.
Suppliers should complete and submit the preprinted reenrollment form as instructed within the required 35 days. The NSC will accept and process these forms as reenrollments. For any other enrollment purpose such as changes of information, enrollment of additional locations or reactivations, suppliers are required to submit the revised CMS 855S.