Revised CMS-855O application: Enrollment solely to order, certify or prescribe

Physicians and non-physician practitioners must use the revised CMS-855O application (Eligible ordering, certifying, and prescribing physicians and other eligible professionals) beginning January 1, 2018. The revised application will be posted on the CMS forms list by early summer. Medicare administrative contractors will accept both the current and revised versions of the CMS-855O through December 31, 2017. Visit the Medicare Provider-Supplier Enrollment webpage for more information about Medicare enrollment.