Pharmacy

Learn how to enroll a Pharmacy into Part B Medicare.

Pharmacy

Application Completion

  • If completing application via PECOS, ensure application questionnaire is answered correctly. CMS-855B, CMS-588 (Electronic Funds Transfer (EFT)) application will populate.
  • If completing application via paper, the following must be submitted:
  • A voided check or signed bank letter is necessary documentation for EFT portion of application
  • Must include legal business name (LBN) of the enrollment, routing and account number and practice address
  • CMS-460 (Participation agreement)
  • Submit application fee
    • Fee is required for application. Can be paid on PECOS website
    • Select pay application fee on right-hand side under Helpful Links

Effective Dates

  • Medicare can go back 30 days from when the application is submitted, or all signatures are received in PECOS.
  • An application can be submitted 60 days in advance of when the enrollment will be active.

Supporting Documents

  • IRS document when:
    • Initial enrollment
    • A change of legal business name
  • A voided check or signed bank letter is necessary documentation for EFT portion of application

 

Last Updated Fri, 28 May 2021 13:30:10 +0000