04/05/2017

CMS Revises CMS-855O Application Required for Non-Participating Providers to Order Imaging Services

AQI Members:

Please be advised that CMS has revised its CMS-855O application required for non-participating providers to order imaging services.

In order for a non-participating provider to order imaging services for Medicare beneficiaries, the provider must submit an enrollment application called a CMS 855O to the applicable Medicare Administrative Contractor.  CMS may deny Part B imaging claims that fail the ordering/referring provider edits because the ordering physician or non-physician practitioner does not have an enrollment record. To avoid claim denials, imaging centers must work with non-participating ordering or referring physicians and non-physician practitioners to make certain that a CMS-855O form or its online Provider Enrollment, Chain and Ownership System (PECOS) equivalent has been filed.  

CMS recently announced that a revised CMS-855O application will be posted on the CMS Forms List by early summer. Medicare Administrative Contractors will accept both the current and revised versions of the CMS-855O through December 31, 2017. Beginning January 1, 2018 only the new version will be accepted.  According to CMS, changes to the form include:

  • New title acknowledging that non-enrolled practitioners who prescribe Part D drugs also use this form.
  • New specialties were added, including Interventional Cardiology and 5 other specialties.
  • Now optional for providers to add an additional contact person.
  • Editorial and formatting corrections in response to public comments.

Please see the Medicare Provider-Supplier Enrollment webpage for additional information or contact Executive Director, Maggie Sayre, with any questions.