{"DID":"crit11bb5d","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-28-2024 09:45","End Date":"09-02-2024 17:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed Monday, September 2, 2024, in observance of Labor Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit13d514","Sites":"JMB^JMHHH^Railroad Beneficiaries","Start Date":"05-23-2024 00:00","End Date":"05-27-2024 23:27","Content":"The Palmetto GBA Railroad Medicare Beneficiary Contact Center (BCC) will be closed on Monday, May 27, 2024, in observance of the Memorial Day holiday.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit34dea1","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"07-22-2024 08:25","End Date":"07-22-2024 08:30","Content":"Web chat is unavailable due to a system outage. We are working to resolve the issue and will remove this banner once the system is available.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit3d5e43","Sites":"JMB","Start Date":"03-11-2024 10:47","End Date":"04-18-2024 09:47","Content":"Join us for Spring Tour 2024: Columbia, S.C. on April 2, 2024, Bessemer, Ala. on April 8, 2024, Cleveland, Tenn. on April 10, 2024, Decatur, Ga. on April 11, 2024, Charleston, W. Va. on April 16, 2024, and Richmond, Va. on April 18, 2024. ","URL":"https://palmettogba.com/palmetto/jmb.nsf/DID/SY9IONT0ZJ","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit4b35ae","Sites":"JJB^JMB","Start Date":"07-26-2024 12:01","End Date":"07-30-2024 23:59","Content":"If you missed our Spring Tour, join us in Columbia, S.C. on July 30, to catch up on the most recent provider education from Palmetto GBA.","URL":"https://web.cvent.com/event/93f37ecc-9d69-4a33-b62b-cbd6232d9aff/summary","Target":"_blank","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crit4e5c4e","Sites":"JJA^JMA^JMB^JMHHH^JJB","Start Date":"06-14-2024 14:06","End Date":"06-20-2024 06:07","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed Wednesday, June 19, 2024, in observance of the Juneteenth holiday. Please note that the chat feature will not be available when the PCC is closed.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}, {"DID":"crit5b152d","Sites":"JJA^JJB^JMA^JMB^Railroad Medicare","Start Date":"09-02-2024 18:00","End Date":"09-22-2024 08:36","Content":"Registration is open for the 2024 MACtoberfest education event in Columbia, S.C. Please plan to attend.","URL":"https://web.cvent.com/event/4c4a964e-0c1a-45a8-a4d4-9d8ead85dc11/summary","Target":"_blank","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"crita42d51","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-31-2023 15:00","End Date":"09-04-2023 17:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, September 4, 2023, in observance of Labor Day.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critaa1545","Sites":"JMB","Start Date":"05-27-2024 00:00","End Date":"05-28-2024 23:27","Content":"Medicare Part B providers are invited to Palmetto GBA's MayFest virtual education event Thursday May 30, 2024.","URL":"https://palmettogba.com/palmetto/jmb.nsf/DIDC/8DRB9MA2C9~Events%20and%20Education","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critb5d1bb","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"09-25-2024 12:55","End Date":"10-04-2024 17:00","Content":"Due to Hurricane Helene, the Provider Contact Center may experience longer than usual wait times.","URL":"","Target":"_self","Color":"yellow","Mode":"Standard\n","Priority":"yes"}, {"DID":"critba251d","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"06-25-2024 15:12","End Date":"07-04-2024 22:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed Thursday, July 4, 2024, in observance of Independence Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critbc45da","Sites":"JJA^JJB^JMA^JMB","Start Date":"08-21-2024 10:45","End Date":"08-23-2024 12:05","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, August 23, 2024, for staff training. Please note that the webchat feature will be unavailable at this time.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critcd1cce","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"09-16-2024 10:40","End Date":"09-16-2024 12:00","Content":"The eServices portal is currently unavailable. We are working to resolve the issue and will remove this banner once the portal is available.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"no"}, {"DID":"critcd5b1b","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"09-16-2024 12:17","End Date":"09-16-2024 14:00","Content":"Currently, the eServices portal is intermittently unavailable. We are working to resolve the issue and will remove this banner once functionality is restored.","URL":"","Target":"_self","Color":"red","Mode":"Standard\n","Priority":"yes"}, {"DID":"critdaa222","Sites":"JJA^JJB^JMA^JMB^JMHHH^Railroad Medicare","Start Date":"06-03-2024 13:45","End Date":"06-03-2024 14:00","Content":"eServices Messages and eDelivery tabs are currently unavailable. The portal will be briefly unavailable on 6/3/24, beginning at 1:40PM and ending at 1:50PM EST to correct this issue.","URL":"","Target":null,"Color":"red","Mode":"Standard\n","Priority":"no"}, {"DID":"critdc3d32","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"05-23-2024 00:00","End Date":"05-27-2024 23:00","Content":"The Palmetto GBA Provider Contact Center (PCC) will be closed Monday, May 27, 2024, in observance of Memorial Day.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"critee34e3","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"08-07-2024 09:00","End Date":"08-09-2024 12:30","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, August 9, 2024, for staff training. Please note that the webchat feature will be unavailable at this time.","URL":"","Target":"_self","Color":"blue","Mode":"Standard\n","Priority":"no"}, {"DID":"criteeae4b","Sites":"JJA^JJB^JMA^JMB^JMHHH","Start Date":"09-10-2024 13:06","End Date":"09-13-2024 13:00","Content":"The Palmetto GBA Jurisdictions J and M Provider Contact Center (PCC) will be closed from 8 a.m. to 12 p.m. ET on Friday, September 13, 2024, for staff training. Please note that the webchat feature will be unavailable at this time.","URL":"","Target":null,"Color":"blue","Mode":"Standard\n","Priority":"yes"}

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

IDTF Diagnostic Tests: CMS-855 Application

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IDTF Diagnostic Tests: CMS-855 Application

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