New Medicare enrollment: Which forms do I need to complete?
CMS' internet-based PECOS (Provider Enrollment, Chain and Ownership System) web system supports the Medicare enrollment process by capturing provider / supplier information from the CMS-855 family of forms. The system manages, tracks, and validates enrollment data electronically via the internet.
To facilitate your application process, we encourage you to use the online, scenario-driven process in internet-based PECOS instead of the paper application process outlined in the table below.
Need help choosing forms? Try our Enrollment Application Assistance Tool.
| Type of provider | 855A | 855B | 855I | 20134 | 588 | 460 | 8292 |
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| Individual or Sole Proprietor (Not Incorporated) |  |
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| Individual Provider (Incorporated) |
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Clinic or Group Practice
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| Organization Part B | |
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| Medicare Diabetes Prevention Program Suppliers |
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| Institutional Provider Part A |
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| View or Download Enrollment Forms >> |
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855B | 855I | 20134 | 588 | 460 | 8292 |
= Required = Optional