“Search” button. Find the “CMS Medicare Application Fee” section and select the “Continue
to the Form” button. Complete the form and submit payment as directed. You will get a
confirmation screen indicating that payment was successfully made. This confirmation screen
is your receipt and should be printed for your records. We strongly recommend that this
receipt be mailed to the Medicare contractor along with the Certification Statement for the
enrollment application. CMS will notify the Medicare contractor that the application fee has
been paid. The Medicare contractor will process the provider enrollment application in the
order in which it was received. Normal processing timeframes apply to your provider
enrollment application.
2. Complete the paper Medicare enrollment application (CMS-855) – Once you have completed
the CMS-855 paper application, you should promptly pay the application fee through
Pay.gov by visiting (
www.pay.gov). (See section below entitled Pay.gov for more
information.) Once you are on Pay.gov, type “CMS” in the search box under “Find Forms,
Agencies…” and click the “Search” button. Find the “CMS Medicare Application Fee”
section and select the “Continue to the Form” button. Complete the form and submit payment
as directed. You will get a confirmation screen indicating your payment was successful. This
confirmation screen is your receipt and should be printed for your records. We strongly
recommend that this receipt be mailed to the Medicare contractor along with the completed
CMS-855 application. CMS also notifies the Medicare contractor that your application fee
has been paid. The Medicare Contractor will process your provider enrollment application in
the order in which it was received. Normal processing timeframes apply to your provider
enrollment application.
Q: Are both my Medicare enrollment application and fee processed by the same agency?
A: No. Your Medicare application is processed by the Medicare contractor via the Provider
Enrollment, Chain and Ownership System (PECOS). The application fee, paid electronically by
check, debit card, or credit card, is processed through Pay.gov.
Q: Who can I contact if I have problems submitting my application fee?
A: You should use the Help Tools available on the Pay.gov site for questions specific to the payment
processing. Other questions regarding payment policies and procedures may be sent to the Medicare
.
Pay.gov
Q: What is Pay.gov?
A: Pay.gov is operated by the U.S. Department of the Treasury and is a web-based application that
allows you to make online payments to government agencies by electronic check, credit card or by
debit from your checking or savings account.
Q: I'm not comfortable with making payments online. Can I mail in my payment or pay over the
phone?
A: No. Do not mail application fee payments. Pay.gov cannot accept payments by mail or phone.
Please note that all fees must be paid via Pay.gov and that paper checks submitted outside of the
Pay.gov process will not be accepted.
Q: Is Pay.gov secure?
A: Yes. Pay.gov uses 128-bit SSL encryption to protect your transaction information while you're
logged in to Pay.gov. In addition, any account numbers you set up in your profile are encrypted
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