When submitting a CMS-855 B application for change of information to an IDTF Provider Number, Section 1 of the Attachment 2 must reflect the specific codes (e.g., codes for global and/or technical services, for which the IDTF intends to perform and submit to Medicare Part B).
- Only those codes listed on Attachment 2 of the CMS-855 B application will be considered for payment
- Attachment 2 must be completed in its entirety
If you have any questions, please contact Jeannie Hill-Parks at (614) 473-7160 or Cherissa Nessley at (614) 473-7175.