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Printed Date: 9/22/2015
Section 6401(a) of the Affordable Care Act (ACA) requires the secretary to impose a fee on each 'institutional provider of medical or other items or services and suppliers.' The fee is to be used by the secretary to cover the cost of program integrity efforts including the cost of screening associated with provider enrollment processes, including those under section 1866(j) and section 1128J of the Social Security Act. Based upon provisions of the ACA, this fee will vary from year-to-year based on adjustments made pursuant to the Consumer Price Index - All Urban Consumers (CPI-U). The application fee is to be imposed on institutional providers that are newly-enrolling, re-enrolling/re-validating or adding a new practice location for applications received on and after Friday, March 25, 2011. CMS has defined 'institutional provider' to mean any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (except physician and non-physician practitioner organizations), or CMS-855S forms or associated Internet-based PECOS enrollment application.
Institutional providers applying to participate in the Medicare program must first submit a completed CMS-855 application. An enrollment application can be submitted in one of two ways:
For more information, please refer to the regulation published to the Federal Register (PDF, 735 KB).
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Last Updated: 12/20/2017