CMS-588 Electronic Funds Transfer (EFT) Authorization Agreement Form Submission - Important Changes Effective August 21, 2023

Effective August 21, 2023, 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. Please refer to the below map to determine your correct NPE contractor.

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.

CMS-588 forms received by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) between August 21, 2023, through November 19, 2023, will be forwarded to the correct NPE contractor. EFT forms received by the DME MAC on or after November 20, 2023, will be rejected and returned to the supplier.

EFT Inquiries

Effective August 21, 2023, 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.

NPE Contact Information:

NPE East Contractor (NPEAST): Novitas Solutions, Inc.

  • PO Box 3704
    Mechanicsburg PA 17055-1863
  • Telephone 866-520-5193 9 a.m. to 5 p.m. ET

NPE West Contractor (NPWEST): Palmetto GBA

  • PO Box 100142
    Columbia SC 29202-3142
  • Telephone 866-238-9652 10 a.m. to 6 p.m. ET

 

Map of United States, indicating NPE East and NPE West states. NPE East states include 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. NPE West states include 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.

 

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