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May 20, 2014

Payment of the Provider Enrollment Application Fee: Outpatient Physical/Occupational Therapy and Speech Pathology Providers Who Bill Medicare Part A

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."

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 or associated Internet-based PECOS enrollment application.

Outpatient Physical/Occupational Therapy and Speech Pathology providers who enroll via the CMS 855-A are included as an "institutional" provider type and are required to pay the provider enrollment application fee upon initial enrollment and when asked to revalidate. The application fee for calendar year (CY) 2014 is $542.


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