All facilities providing services to Medicare patients must use the revised CMS-855S (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers) application.

National Provider Enrollment DME contractors (NPEs) will accept the current and revised versions of the CMS-855S through April 7, 2023. After April 7, 2023, only the revised application will be accepted. Visit the Medicare Provider Enrollment and Certification webpage for more information about Medicare enrollment.

Changes to the form include:

• Added Medical Record Correspondence Address to Section 4B2
• Revised Section 2E: Products and Accreditation Information to collect whether the supplier fills orders, fabricates or fits items by contracting with other companies.

Click here for the revised CMS-855S form and additional guidance.