In the final rule issued on February 2, 2011, CMS also finalized a new enrollment application fee for “institutional providers.” The fee, initially set at $500 per application, will be used to cover the cost of program integrity efforts, such as the screening procedures discussed in Part I of this blog series. The fee is applicable to all institutional providers who are submitting an initial application, who are currently enrolled and submitting an application to establish a new practice location, and providers responding to a revalidation request from CMS. Implemented for applications after March 25, 2011, the fee will be adjusted annually based on the consumer price index.

In the Final Rule, CMS defines “institutional providers” as any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B, and CMS-855S or the associated internet-based PECOS application. Notably, however, the regulations exclude individual physicians, non-physician practitioners, and Part B medical groups and clinics from the application fee requirement.