How to Enroll in Medicare Electronic Data Interchange
Guidance for CMS standard Electronic Data Interchange (EDI) enrollment form to be completed prior to submitting Electronic Media Claims (EMCs) or other EDI transactions to Medicare.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 07, 2016
The Centers for Medicare & Medicaid Services (CMS) standard Electronic Data Interchange (EDI) enrollment form must be completed prior to submitting Electronic Media Claims (EMCs) or other EDI transactions to Medicare. The agreement must be executed by each provider of health care services, physician, or supplier that intends to submit EMC or use EDI, either directly with Medicare or through a billing service or clearinghouse.
Each new EMC biller must sign the form and submit it to their local Medicare Administrative Contractor (MAC) or Durable Medicare Equipment (DME) MAC.
For more information regarding the CMS Standard EDI Enrollment Form, please contact your local A/B MAC or DME MAC.
An organization comprising of multiple components that have been assigned Medicare provider numbers, supplier numbers, or UPINs may elect to execute a single EDI Enrollment Form on behalf of the organizational components to which these numbers have been assigned. The organization as a whole is held responsible for the performance of its components.
See the Medicare Claims Processing Manual (Pub.100-04), Chapter 24, and Sections 30 – 30.4 for further information.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.