How Institutional Providers Will Pay the Medicare Enrollment Application Fee beginning Friday, March 25
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. The application fee is $542 for CY2014. 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:
Pay.gov is operated by the US Department of the Treasury and is a Web-based application that allows you to make online payments to government agencies by electronic check, credit card or debit from your checking or savings account. Pay.gov accepts Visa, MasterCard, American Express and Discover. Do not mail application fee payments. Pay.gov cannot accept payments by mail or phone. Please note that all fees must be paid via Pay.gov and that paper checks will not be accepted. Users need not worry about submitting the incorrect amount; CMS has pre-populated the field for the correct payment amount for the specific calendar year. Users may not make multiple payments in one transaction and must make separate payments for each application.
CMS has reviewed the security of Pay.gov and is confident in the measures used to protect its users. Pay.gov uses 128-bit SSL encryption to protect your transaction information while you're logged in to Pay.gov. In addition, any account numbers you set up in your profile are encrypted before being stored in our database. When you access your profile, any account numbers you have entered will be masked on-screen; each account number in your profile will be displayed as a group of asterisks followed by the last four digits of the account number.
Your Medicare application is processed by the Medicare contractor via the Provider Enrollment, Chain, and Ownership System (PECOS). The application fee, which is paid electronically by check, debit card or credit card, is processed through Pay.gov. Therefore, if you have problems submitting your application fee, you should use the Help Tools available on the Pay.gov site for questions specific to the payment processing. Other questions regarding payment policies and procedures may be sent to the Medicare provider and supplier enrollment e-mail account at Dpse_admin@cms.hhs.gov.
For more information, please refer to the regulation published to the Federal Register (PDF, 636 KB). For additional clarification, look out for an official MLN Matters Article that will be released on the subject in the near future.
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