42 CFR 424.505
§ 424.505 Basic enrollment requirement.
United States · 42 CFR — Public Health · Status: effective
Cite this
- Citation
- 42 CFR 424.505, § 424.505 Basic enrollment requirement, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/205239
- Permanent ID
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Full text
To receive payment for covered Medicare items or services from either Medicare (in the case of an assigned claim) or a Medicare beneficiary (in the case of an unassigned claim), a provider or supplier must be enrolled in the Medicare program. Except for those suppliers that complete the CMS-855O form or CMS-identified equivalent, successor form or process for the sole purpose of obtaining eligibility to order or certify Medicare-covered items and services; once enrolled the provider or supplier receives billing privileges and is issued a valid billing number effective for the date a claim was submitted for an item that was furnished or a service that was rendered. (See 45 CFR part 162 for information on the National Provider Identifier and its use as the Medicare billing number.)
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.