Electronic Funds Transfer (EFT)
Electronic Funds Transfer (EFT) deposits your Medicare payments directly into your bank account. CMS requires that all providers that are enrolling in Medicare Part B, revalidating, or making any changes to their file, must use EFT. To sign up, complete an Electronic Funds Transfer Authorization Agreement - CMS 588 . Complete the form and have it signed and dated by the provider or authorized/delegated official (for groups or organizations). The signature must be original (can not be a copy or stamped signature).
Under the Physician/Provider/Supplier Information section, the form asks for "Medicare Identification Number". In this field, please indicate your Medicare Part B PTAN with Noridian. This field can be left blank if you are submitting the EFT form with an initial enrollment application. Please also indicate your NPI in the NPI field on the form. Include a letter from the bank that verifies the type of account, routing number, and bank account number. The EFT can only be established with financial institutions. Brokerage houses and mutual funds are not acceptable for EFT deposits. You will be informed of the exact date that your EFT will begin via a letter.
A group does not need to submit an EFT form for each of its members. Only the group submits the form and indicates the group PTAN in the Medicare Identification Number field.
To change account numbers or bank routing numbers, fill out a CMS 588 EFT form, using the new account/routing information and include a bank letter indicating the new information. If your account changes from checking to savings or vice versa, a new EFT form must also be completed.
Return the form to the address listed for your state, found on the Provider Enrollment Contacts page.
Last Updated Feb 19, 2015