Mammography Screening Center - JF Part B

A screening mammography is a radiologic procedure. This is furnished to a woman without signs or symptoms of breast disease, for the purpose of early detection of breast cancer, and includes a physician's interpretation of the results of the procedure.

A supplier of screening mammography is a facility that is certified and responsible for ensuring that all screening mammography services furnished to Medicare beneficiaries meet the conditions and limitations for coverage of screening mammography services.

All information can be found in CMS Internet Only Manual (IOM), Publication 100-08, Chapter 15, Section 15.4.2.3

• Application Completion
• Effective Dates
• Supporting Documentation
• Resources

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:
  • CMS-855B
  • CMS-588 (EFT)
• 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)
  • This is optional.
  • View Participation webpage for details
• 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
• Valid provisional certificate, or a valid certificate, that has been issued by the Food and Drug Administration (FDA) indicating that the supplier meets the certification requirements
  • The FDA is responsible for collecting certificate fees and surveying mammography facilities (screening and diagnostic)

Resources

• CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 18
• CMS IOM, Publication 100-02, Medicare Benefit Policy Manual, Chapter 15
• 42 CFR § 410.34-Federal Register