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Revised CMS-855S Required by March 10, 2023


Eligible suppliers must use the revised CMS-855S (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers) application beginning January 9, 2023. The revised application will be posted on the CMS Forms List (CMS Forms List | CMS).

National Provider Enrollment DME contractors (NPEs) will accept the current and revised versions of the CMS-855S through April 7, 2023. After April 7, 2023, only the revised application will be accepted. Visit the Medicare Provider Enrollment and Certification webpage (Provider Enrollment and Certification | CMS) for more information about Medicare enrollment.

Changes to the form include:

  • Added Medical Record Correspondence Address to Section 4B2
  • Revised Section 2E: Products and Accreditation Information to collect whether the supplier fills orders, fabricates or fits items by contracting with other companies.

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