Implementation of Application Fees for Medicare Provider/Supplier Enrollment

Effective Friday, March 25, 2011, Medicare Administrative Contractors (MACs) will begin collecting application fees with certain provider/supplier enrollment applications (both paper and online applications) as described below. The application fee is currently $505 for CY2011; however, this fee will vary from year-to-year based on adjustments made pursuant to the Consumer Price Index for Urban Areas (CPI-U).

Note that these application fees do not apply to physicians, non-physician practitioners, physician organizations, and non-physician organizations. All institutional providers of medical or other items or services or suppliers must pay the application fee. (‘‘Institutional provider’’ includes any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A; CMS-855B, not including physician and non-physician practitioner organizations; CMS-855S; or the associated Internet-based PECOS enrollment applications).

All application fees must be submitted via paper check, until CMS specifies a mechanism for submitting electronic funds at a future date. Note also that MACs will accept hardship exception requests from institutional providers; however, determinations on whether to grant these requests will be made on a case-by-case basis. CMS and its contractors will not be able to process any applications without the proper application fee having been paid and credited to the United States Treasury or an approved hardship exception. If the fee is not submitted, the application will be rejected or billing privileges revoked (as applicable) unless a hardship exception request is subsequently granted. If CMS has denied a hardship exception request, then an institutional provider has thirty days to submit the application fee to the CMS contractor.

For more information, please refer to the regulation published to the Federal Register at http://www.GPO.gov/fdsys/pkg/FR-2011-02-02/pdf/2011-1686.pdf. And for additional clarification, look out for an official MLN Matters Article that will be released on the subject in the near future.



Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555, Ext. 200.