Certified Provider and State Survey Agency

In addition to completing and submitting the Medicare enrollment applications, the certified provider must meet all federal requirements. The State Survey Agency can provide precertification assistance.

Prospective provider/supplier must contact the SA for certification materials for their provider/supplier type. If the applicant has not contacted the SA before the SA receives the MAC's recommendation for approval, it will delay the enrollment process.

Contact the SA as soon as a decision is made to enroll with Medicare or make a change to the Medicare information!

Certified Providers/Suppliers

View Centers for Medicare & Medicaid Services (CMS) Internet-only-Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 10 (sections listed below) for additional information on certified provider/suppliers.

Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A

10.2.1.1 – Community Mental Health Centers (CMHCs)

10.2.1.2 – Comprehensive Outpatient Rehabilitation Facilities (CORFs)

10.2.1.3 – End-Stage Renal Disease Facilities (ESRDs)

10.2.1.4 – Federally Qualified Health Centers (FQHCs)

10.2.1.5 – Histocompatibility Laboratories

10.2.1.6 – Home Health Agencies (HHAs)

10.2.1.7 – Hospices

10.2.1.8 – Hospitals and Hospital Units

10.2.1.9 – Indian Health Services (IHS) Facilities

10.2.1.10 – Organ Procurement Organizations (OPOs)

10.2.1.11 – Outpatient Physical Therapy/Outpatient Speech Pathology

10.2.1.12 – Religious Non-Medical Health Care Institutions (RNHCIs)

10.2.1.13 – Rural Health Clinics (RHCs)

10.2.1.14 – Skilled Nursing Facilities (SNFs)

Certified Suppliers That Enroll Via the Form CMS-855B

10.2.2.1 – Ambulatory Surgical Centers (ASCs)

10.2.2.3 – Independent Clinical Laboratory Improvement Act (CLIA) Labs

10.2.2.8 – Portable X-Ray Suppliers (PXRSs)

Related Content

• Understanding the Approval Recommendation Process for Certified Providers

Revised 2/9/2023