Application Fee

Some providers submitting a CMS-855B form, or associated PECOS application, pay a fee for initial enrollment, revalidation, adding a practice location and re-enrolling. Physician and non-physician practitioner organizations do not pay this fee. The application fee varies from year-to-year. See the CMS Medicare Application Fee webpage for information on how the fee is determined.

Providers/suppliers who are required to submit an application fee

Any provider/supplier submitting a CMS-855B form (via web or paper) to initially enroll, add a practice location or to revalidate, including but not limited to:

  • Ambulances
  • Ambulatory Surgery Centers
  • Federally Qualified Health Centers
  • Histocompatibility Labs
  • Hospitals
  • Independent Clinical Labs
  • Independent Diagnostic Testing Facilities
  • Mammography Screening Centers
  • Mass Immunization Roster Billers
  • Pharmacies
  • Portable X-Ray Suppliers
  • Radiation Therapy Centers
  • Rural Health Clinics

Submit the application fee

Providers can submit their fee by going to the Provider Enrollment, Chain, and Ownership System (PECOS) Welcome Application Fee Information page.

Providers/suppliers who feel they are unable to pay this fee

Providers/Organizations/Suppliers are allowed to submit a hardship exception request. This request MUST accompany the application (paper form or with a certification statement if using PECOS web) or a fee will be required instead. The request will be reviewed and approved or denied within 60 days. Any hardship exception requests received separately from an application will not be considered and the provider will be required to submit a fee.

Next steps if the hardship exception request is denied

Providers have 30 days to submit their application fee or their application will be rejected or revoked. Providers may appeal this denial within 60 calendar days of the receipt of the decision letter. The appeal request should be sent to:

Centers for Medicare & Medicaid Services
Center for Program Integrity
Provider Enrollment Operations Group
7500 Security Boulevard
Mailstop: AR 18-50
Baltimore, MD 21244-1850

Find out more about application fees

See CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 15, Section 15.19.1 has more information on the background of application fees and more information on the criteria for determining hardship.

 

Last Updated Oct 23, 2018