IDTF Diagnostic Tests: CMS-855 Application

Published 02/02/2019

When submitting a CMS-855B (PDF, 661 KB) 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