Enrollment

National Provider Enrollment (NPE)

Looking to become a DME Medicare supplier or are you a DME Medicare supplier who needs to make an update to your enrollment file?

Two contractors process all DMEPOS enrollment applications based on the physical location of the supplier’s office:

Novitas Solutions NPE East: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands

Palmetto GBA NPE West: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands

These two contractors are responsible for issuing or revoking Medicare supplier billing privileges for suppliers of DMEPOS. Once the requirements have been met to become a DMEPOS supplier, a Provider Transaction Access Number (PTAN) is issued to the supplier for billing privileges. The PTAN is sometimes referred to as the NSC number. Read articles; access learning & educational information; view resources and contact details; and learn about Supplier enrollment related processes, rules, and regulations including supplier standards on the enrollment contractors websites.

Provider Enrollment Applications

CMS-855S application

The Provider Enrollment, Chain, and Ownership System (PECOS) is the quickest, most efficient way to complete and submit your enrollment applications. PECOS supports the Medicare supplier enrollment process by allowing registered users to securely submit and manage Medicare enrollment information online.

If you decide to submit paper applications instead, they can be uploaded and submitted using the Novitas Provider Enrollment Gateway. This tool can also be used to submit responses to development requests requesting a copy of enrollment correspondence, or to check the status of a previously uploaded application This gateway only applies to the NPEast suppliers

Surety Bond

Suppliers seeking to enroll or changing the ownership of a DMEPOS supplier must submit a $50,000 surety bond for each assigned National Provider Identifier (NPI) for which the DMEPOS supplier is seeking to obtain Medicare billing privileges. Please see the surety bond page for more information.

Appeals & Rebuttals

Suppliers may send enrollment appeals and rebuttals to Chags Health Information Technology LLC (C-HIT):

Mailing Address:

C-HIT
P.O. BOX 45266
Jacksonville, FL 32232

Fax: (866) 410-7404

Phone: (800) 245-9206

E-mail: PEARC@c-hit.com

Participating vs non-Participating

Electronic Funds Transfer (EFT) Enrollment

Requirement to Receive Medicare Payments Via Electronic Funds Transfer (EFT) to Avoid Deactivation of Medicare Billing Privileges

In accordance with 42 CFR 424.510(e)(1), and CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10, Section 10.6.10 , all providers and suppliers are required to receive payments via electronic funds transfer. If an EFT form is not submitted by the due date of July 24, 2024, Medicare billing privileges will be deactivated.

Enrolling

CMS-588 Electronic Funds Transfer (EFT) Authorization Agreements must be sent to the applicable National Provider Enrollment (NPE) contractor for the supplier’s physical location.

Bank information must be applicable for all four jurisdictions. The Part III Financial Institution Information listed on the EFT agreement must be the same for all jurisdictions, regardless of the supplier’s physical address.

EFT Inquiries

Suppliers must contact the appropriate NPE contractor for all inquiries related to electronic funds transfers. This includes questions about all other EFT correspondence sent to suppliers by the DME MACs or the NPE contractors, status of EFT requests, and changes in EFT information.

This is supported by 42 Code of Federal Regulations (CFR) § 424.510 - Requirements for enrolling in the Medicare program:

(e) Providers and suppliers must -

(1) Agree to receive Medicare payment via electronic funds transfer (EFT) at the time of enrollment, revalidation, change of Medicare contractors where the provider or supplier was already receiving payments via EFT or submission of an enrollment change request. and

(2) Submit the CMS-588 form to receive Medicare payment via electronic funds transfer.

The enrollment contractors will notify you when you must transition from paper checks to EFT.

When to Contact the National Provider Enrollment Contractors vs. the DME MAC

Call NPEAST or NPWEST, based on the physical location of your supplier’s office as outlined at the beginning of this page, at the following phone numbers for the following topics:

NPEAST-Novitas Solutions Phone: 866-520-5193 9 a.m. - 5 p.m. ET

NPWest-Palmetto GBA Phone: 866-238-9652 10 a.m. - 6 p.m. ET

  • Payment Hold or Do Not Forward Questions: Contact your DME MAC to inquire on the type of payment hold in place. The call representative will advise how to have the payment hold removed, which may involve contacting the NPE contractors.
  • Setting up Electronic Fund Transfer (EFT) or making EFT changes
  • Providing documentation to establish enrollment compliance such as proof of insurance, surety bond, licenses, or other documents
  • Reactivation status for a PTAN (Provider Transaction Access Number)
  • To check why a PTAN was deactivated or revoked
  • Reporting changes in ownership
  • Updating supplier enrollment records

The only involvement Noridian has in the enrollment process is generating overpayments as directed by the NPEs or CMS when a PTAN is deactivated or revoked. Noridian will send an overpayment letter. This letter will explain how to appeal if you disagree with the overpayment decision.

All other enrollment related direction comes from the NPEs or the Appeals and Rebuttals Contractor, Chags Health Information Technology (C-HIT), as they handle enrollment related appeals and implementing appeal decisions. Please ensure that you are responding to these letters and not to Noridian to resolve your PTAN reactivation or appeals process. Noridian will not forward documentation to other contractors on your behalf.

To check on the status of an enrollment appeal or corrective action plan for revocation/termination of a PTAN, call or email C-HIT at 800-245-9206 or PEARC@c-hit.com

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