Enrollment

Medicare Part B covers OTP services at freestanding OTP facilities and hospital outpatient departments. As an OTP, you can enroll as a Part A or a Part B provider for this Part B benefit. 

OTPs fully-certified by the SAMHSA and accredited by a SAMHSA-approved accrediting body can enroll in the Medicare Program to bill for covered services.

Institutional Providers

You enroll in the Medicare Program using either:

• PECOS
• Medicare Enrollment Application for Institutional Providers: CMS-855A (PDF)

You’ll submit claims electronically using the 837 Institutional (837I) or the paper claim Form CMS-1450.

Professional Providers

You enroll in the Medicare Program using either:

• PECOS
• Medicare Enrollment Application for Clinics, Group Practices, and Certain Other Suppliers: CMS-855B (PDF)

You’ll submit claims electronically using the 837  Professional (837P) or the paper claim Form CMS-1500 (PDF).

Visit the Medicare Provider Enrollment educational tool to guide you through the process. 

Resources

• CMS Fingerprinting Instruction website
• External User Services (EUS) for Medicare Providers
• Medicare Administrative Contractor (MAC) Enrollment Contacts (PDF)
• Medicare Billing: 837I & Form CMS-1450 (PDF) fact sheet
• Medicare Billing: 837P & Form CMS-1500 (PDF) fact sheet
• National Plan & Provider Enumeration System (NPPES)
• NPPES FAQs
• PECOS FAQs