CMS Request for electronic funds transfer (EFT) form for DMEPOS providers

All DME Suppliers Should Act Immediately

All DME suppliers – even those that didn’t receive one of the April 25 letters – should ensure that none of their locations receive paper checks from Medicare hasta pronto!

For any locations that do, suppliers should:

1. Submit Form CMS-588 and a copy of a voided check to the applicable enrollment contractor before July 24, 2024. Be sure an authorized or delegated official from PECOS signs the enrollment document.
2. Attach a copy of the April 25 letter for easier enrollment processing. If the letter is not available, we recommend suppliers prepare an attachment listing NPIs and PTANs.

Depending on the supplier location, CMS-588 submission instructions are available at:

1. NPE East – https://www.novitas-solutions.com/webcenter/portal/DMEPOS/pagebyid?contentId=00291192
2. NPE West – https://www.palmettogba.com/palmetto/npewest.nsf/DID/CHEQ2K5614