Certified Provider and State Survey Agency
Table of Contents
- Certified Provider and State Survey Agency
- Certified Providers/Suppliers
- Certified providers and certified suppliers that enroll via the form CMS-855A
- Certified suppliers that enroll via the form CMS-855B
- Related Content
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 CMS Internet-only-Manual, Medicare Program Integrity Manual, Publication 100-08, 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
Revised 2/9/2023
Helpful Resources
Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee
J6 Mailing Address:
National Government Services, Inc.
P.O. Box 6475
Indianapolis, IN 46206-6475
Interactive Voice Response:
877-908-9499
Contact Enrollment:
877-908-8476
Hours Available:
Monday–Friday
8:00 a.m.–4:00 p.m. CT
Form(s) you'll need:
Helpful Resources
Check Provider Enrollment Application Status
Log Into PECOS
Pay Application Fee
JK Mailing Address:
National Government Services, Inc.
P.O. Box 7149
Indianapolis, IN 46207-7149
Interactive Voice Response:
877-869-6504
Contact Enrollment:
888-379-3807
Hours Available:
Monday–Friday
8:00 a.m.–4:00 p.m. ET
Form(s) you'll need: