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How to Submit Reassignment of Benefits Using the Revised CMS-855I. Physicians and non-physician practitioners can enroll and report reassignments using either: The Provider Enrollment, Chain and Ownership System (PECOS), or. The Paper CMS-855I Application.
The CMS-855R (Reassignment of Medicare Benefits) form has been discontinued. For additional information regarding the Medicare enrollment process (including Internet-based PECOS) and to get the current version of the CMS-855I, go to CMS.gov/Medicare/Provider-Enrollment-and-Certification.
Learn how to initially enroll, revalidate, and submit changes of information for individual providers. Cover all aspects of completing the CMS-855I & 855R with a walkthrough of both the paper and PECOS versions of the form. Learn how to avoid common mistakes when submitting the 855-I&R. •.
• The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or • The paper CMS-855R application. Be sure you are using the most current version.
Medicare has merged the CMS-855R into the CMS-855I paper enrollment application. Physicians and non-physician practitioners can reassign your right to bill the Medicare program and receive Medicare payments for some or all the services you render to Medicare
terminate a reassignment of Medicare benefits after enrollment in the Medicare program or make a change in their reassignment of Medicare benefit information using either: • The Internet-based Provider Enrollment, Chain and Ownership System (PECOS), or • The paper CMS-855R application. Be sure you are using the most current version.
Processing the CMS-855R Medicare Enrollment Application - Reassignment of Benefits. Guidance for providers and suppliers in completing the CMS-855R application and MACs in processing the CMS-855R application. Download the Guidance Document
