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Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version

Effective 4/30/2024 the MACs may only accept the CMS-588 EFT (11/23) version, the outdated form will be returned.

NOTE: An electronic application submission via PECOS with the banking information added or updated under the topic view “Electronic Funds Transfer” and upload a voided check or bank confirmation letter under “Required and/or Supporting Documentation” with the required signature and date, replaces completing the paper CMS-588 (11/23) form.

Posted 3/25/2024