Medicare Program Integrity Manual
Chapter 15 - Reserved for Future Use
Table of Contents
(Rev. 10945, 08-12-21)
Transmittals for Chapter 15
Transmittals Issued for this Chapter
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
| R10945PI |
08/12/2021 |
Removal of Provider Enrollment Policy from Chapter 15 in Publication (Pub.) 100-08 |
09/13/2021 |
12391 |
| R10723PI |
04/08/2021 |
Implementation of Provider Enrollment Provisions in CMS-6058-FC – Phase 1 – Continued Removal/Moving of Instructions from Chapter 15 of Publication (Pub.) 100-08 to Chapter 10 of Pub. 100-08 |
08/10/2020 |
11551 |
| R10611PI |
03/19/2021 |
Completion of Removal/Moving of Instructions from Chapter 15 of Publication (Pub.) 100-08 to Chapter 10 of Pub. 100-08 |
11/19/2020 |
11917 |
| R10524PI |
12/17/2020 |
Chapter 15 of Publication (Pub.) 100-08 Manual Redesign – Additional Release of Chapter 10 |
11/13/2020 |
11700 |
| R10383PI |
10/09/2020 |
Updates to Chapters 4, 5, 8, 15, and Exhibits of Publication (Pub.) 100-08 |
11/10/2020 |
11999 |
| R10355PI |
09/18/2020 |
Completion of Removal/Moving of Instructions from Chapter 15 of Publication (Pub.) 100-08 to Chapter 10 of Pub. 100-08- Rescinded and replaced by transmittal 10611 |
11/19/2020 |
11917 |
| R10353PI |
09/11/2020 |
Chapter 15 of Publication (Pub.) 100-08 Manual Redesign – Additional Release of Chapter 10 of Pub. 100-08, Modification of the Timeliness Standards |
02/01/2021 |
11865 |
| R10345PI |
09/11/2020 |
Chapter 15 of Publication (Pub.) 100-08 Manual Redesign – Additional Release of Chapter 10- Rescinded and replaced by transmittal 10524 |
11/13/2020 |
11700 |
| R10239PI |
07/28/2020 |
Implementation of Provider Enrollment Provisions in CMS-6058-FC – Phase 1 – Continued Removal/Moving of Instructions from Chapter 15 of Publication (Pub.) 100-08 to Chapter 10 of Pub. 100-08- Rescinded and replaced by Transmittal 10723 |
08/10/2020 |
11551 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
| R10182PI |
06/15/2020 |
Update to Chapter 10 of Publication (Pub.) 100-08 - Model Letter Templates |
09/16/2020 |
11375 |
| R10146PI |
05/22/2020 |
Implementation of Provider Enrollment Provisions in CMS-6058-FC – Phase 1 – Continued Removal/Moving of Instructions from Chapter 15 of Publication (Pub.) 100-08 to Chapter 10 of Pub. 100-08- Rescinded and replaced by Transmittal 10239 |
07/24/2020 |
11551 |
| R10138PI |
05/15/2020 |
Moving Chapter 15 (Medicare Enrollment) Manual Instructions in Publication (Pub.) 100-08 to Chapter 10 (Medicare Enrollment) |
06/16/2020 |
11546 |
|
11/22/2019 |
Additional Guidance on Private Contracting/Opting-out of Medicare and Entering Opt-out Affidavit Records in the Provider Enrollment, Chain and Ownership System (PECOS) |
12/24/2019 |
10939 |
| R904PI |
09/27/2019 |
Provider Enrollment Rebuttal Process |
12/31/2019 |
10978 |
| R902PI |
09/27/2019 |
Updates to Chapters 3, 4, 8, 15, and Exhibits of Publication (Pub.) 100-08 |
10/28/2019 |
11425 |
| R898PI |
09/06/2019 |
Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) 100-08, Program Integrity Manual, and to the CMS-855R Processing Guide |
10/07/2019 |
11371 |
| R896PI |
08/30/2019 |
Updates to Provider Enrollment Processing Instructions in Chapter 15 of Publication (Pub.) 100-08 |
10/01/2019 |
11325 |
| R882PI |
05/24/2019 |
Additional Processing Procedure for Adding a New Provider-Based Location for Critical Access Hospitals (CAHs) |
06/25/2019 |
11246 |
| R865PI |
02/21/2019 |
Update to Chapter 15 of Publication (Pub.) 100-08 |
03/12/2019 |
10954 |
| R862PI |
02/08/2019 |
Update to Chapter 15 of Publication (Pub.) 100-08- Rescinded and replaced |
03/12/2019 |
10954 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
by Transmittal 865 |
|
|
| R824PI |
09/05/2018 |
Update to Chapter 15 of Publication (Pub.) 100-08, Certification Statement Policies |
10/01/2018 |
10845 |
| R822PI |
08/24/2018 |
Update to Chapter 15 of Publication (Pub.) 100-08, Certification Statement Policies- Rescinded and replaced by Transmittal 824 |
10/01/2018 |
10845 |
| R797PI |
06/01/2018 |
Reviewing for Adverse Legal Actions (ALA) |
04/30/2018 |
10558 |
| R762PI |
04/30/2017 |
Update to Chapter 15 of Pub. 100-08 |
01/29/2018 |
10386 |
| R782PI |
03/30/2018 |
Update to Chapter 15 of Publication 100-08 - Medicare Enrollment Deactivation Policies |
04/30/2018 |
10443 |
| R784PI |
03/30/2018 |
Reviewing for Adverse Legal Actions (ALA) |
04/30/2018 |
10558 |
| R773PI |
02/23/2018 |
Form CMS-855O Processing Guide |
03/23/2018 |
10355 |
| R765PI |
01/08/2018 |
Medicare Diabetes Prevention Program (MDPP) Enrollment Process |
01/19/2018 |
10356 |
| R734PI |
07/28/2017 |
Update to Reporting Requirements |
06/27/2017 |
9924 |
| R719PI |
05/26/2017 |
Update to Reporting Requirements |
06/27/2017 |
9924 |
| R718PI |
05/19/2017 |
Reviewing for Adverse Legal Actions (ALA) |
06/20/2017 |
9879 |
| R717PI |
05/12/2017 |
Update to Pub. 100-08, Chapter 15 |
05/15/2017 |
9953 |
| R715PI |
05/11/2017 |
Update to Pub. 100-08, Chapter 15 |
06/13/2017 |
9953 |
| R711PI |
04/25/2017 |
Update to Pub. 100-08, Chapter 15 |
05/15/2017 |
9953 |
| R710PI |
04/14/2017 |
Update to Pub. 100-08, Chapter 15 |
05/15/2017 |
9953 |
| R689PI |
12/09/2016 |
Clarification of Certification Statement Signature and Contact Person Requirements |
01/09/2017 |
9776 |
| R688PI |
11/18/2016 |
Update to Pub. 100-08, Chapter 15 |
07/26/2016 |
9635 |
| R685PI |
11/03/2016 |
Incorporation of Cycle 2 Revalidation Policies |
09/06/2016 |
9628 |
| R684PI |
11/01/2016 |
Incorporation of Cycle 2 Revalidation Policies – Rescinded and replaced by Transmittal 685 |
12/02/2016 |
9628 |
| R681PI |
10/27/2016 |
Revision to Surety Bond Collection |
01/30/2017 |
9755 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
Procedures |
|
|
| R676PI |
09/16/2016 |
Clarification of Certain Policies in Pub. 100-08, Chapter 15 Regarding the Processing of Form CMS-855R Applications |
12/19/2016 |
9552 |
| R666PI |
08/05/2016 |
Incorporation of Cycle 2 Revalidation Policies - Rescinded and replaced by Transmittal 684 |
09/06/2016 |
9628 |
| R659PI |
06/24/2016 |
Update to Pub. 100-08, Chapter 15 - Rescinded and replaced by Transmittal 688 |
07/26/2016 |
9635 |
| R636PI |
02/04/2016 |
Update to Pub. 100-08, Chapter 15 |
03/04/2016 |
9390 |
| R626PI |
11/13/2015 |
Update to Surety Bond Collection Requirements |
12/14/2015 |
9296 |
| R609PI |
08/14/2015 |
Clarification Regarding the Processing of Certain Provider Enrollment-Related Transactions |
11/02/2015 |
9174 |
| R605PI |
07/31/2015 |
Clarification Regarding the Processing of Certain Provider Enrollment-Related Transactions – Rescinded and replaced by Transmittal 609 |
11/02/2015 |
9174 |
| R592PI |
05/08/2015 |
Update of Provider Enrollment Instructions in Chapter 15 of Pub. 100-08 |
06/08/2015 |
9139 |
| R591PI |
05/08/2015 |
Revisions to Surety Bond Collection Policies |
06/08/2015 |
9123 |
| R590PI |
04/24/2015 |
Update of CMS-855A, Physician-Owned Hospital Reporting Via the CMS-855POH and Indirect Payment Procedure Registration Via the CMS-855C in Chapter 15 of Pub. 100-08 |
05/25/2015 |
9120 |
| R587PI |
04/17/2015 |
Clarification of Ordering and Certifying Documentation Maintenance Requirements |
07/20/2015 |
9112 |
| R582PI |
03/04/2015 |
Incorporation of Certain Provider Enrollment Policies in CMS-6045-F into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 |
05/28/2015 |
9065 |
| R581PI |
02/27/2015 |
Incorporation of Certain Provider Enrollment Policies in CMS-6045-F into Pub. 100-08, Program Integrity Manual |
05/28/2015 |
9065 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
(PIM), Chapter 15 – Rescinded and replaced by Transmittal 582 |
|
|
| R578PI |
02/25/2015 |
Incorporation of Revalidation Policies into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 |
05/15/2015 |
9011 |
| R575PI |
02/13/2015 |
Incorporation of Revalidation Policies into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 – Rescinded and replaced by Transmittal 578 |
05/15/2015 |
9011 |
| R561PI |
12/12/2014 |
Incorporation of Certain Provider Enrollment Policies in CMS-4159-F into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 |
04/18/2015 |
8901 |
| R556PI |
11/26/2014 |
Revisions to Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 |
12/29/2014 |
8810 |
| R539PI |
08/29/2014 |
Cardiac Rehabilitation Programs for Chronic Heart Failure – Rescinded and replaced with Transmittal 539 |
08/18/2014 |
8758 |
| R532PI |
08/01/2014 |
Incorporation of Various Form CMS-855 Processing Activities into Pub. 100-08, Program Integrity Manual (PIM), Chapter 15 |
09/02/2014 |
8842 |
| R530PI |
07/18/2014 |
Cardiac Rehabilitation Programs for Chronic Heart Failure – Rescinded and replaced with Transmittal 539 |
08/18/2014 |
8758 |
| R525PI |
06/27/2014 |
Update to Form CMS-855 Application Processing Sections of CMS Pub. 100-08, Chapter 15 |
07/29/2014 |
8637 |
| R521PI |
06/13/2014 |
Submission of Community Mental Health Center (CMHC) Certifications of Compliance with Section 485.918(b)(1) |
07/15/2014 |
8784 |
| R519PI |
05/30/2014 |
Revision to CMS Publication 100-08, Chapter 15 |
07/31/2014 |
8512 |
| R517PI |
05/16/2014 |
Update to Surety Bond Collection Procedures |
06/17/2014 |
8636 |
| R514PI |
05/02/2014 |
Update to CMS Publication 100-08, Chapter 15 |
06/03/2014 |
8682 |
| R509PI |
03/27/2014 |
Change in Provider Enrollment Timeliness Standards |
06/02/2014 |
8551 |
| R507PI |
02/28/2014 |
Change in Provider Enrollment |
05/29/2014 |
8551 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
Timeliness Standards – Rescinded and replaced by Transmittal 509 |
|
|
| R503PI |
01/24/2014 |
Inter-Jurisdictional Reassignments |
02/25/2014 |
8545 |
| R502PI |
01/17/2014 |
Registration of Entities Using the Indirect Payment Procedure (IPP) |
01/06/14 |
8284 |
| R499PI |
12/27/2013 |
Update to Chapter 15 of the Program Integrity Manual |
01/28/2014 |
8544 |
| R494PI |
12/06/2013 |
Registration of Entities Using the Indirect Payment Procedure (IPP) |
01/06/14 |
8284 |
| R492PI |
12/06/2013 |
Additional Updates to Chapter 15 of the Program Integrity Manual (PIM) |
01/07/2014 |
8393 |
| R490PI |
11/06/2013 |
Reassignment to Part A Critical Access Hospitals Billing Under Method II (CAH II) |
01/06/2014 |
8387 |
| R483PI |
08/16/2013 |
Reassignment to Part A Critical Access Hospitals (CAHs), Federally Qualified Health Centers (FQHCs), and Rural Health Clinics (RHCs) – Rescinded and replaced by Transmittal 490 |
01/06/2014 |
8387 |
| R479PI |
08/01/2013 |
Enrollment Denials When an Existing or Delinquent Overpayment Exists |
10/07/2013 |
8039 |
| R478PI |
08/02/2013 |
Registration of Entities Using the Indirect Payment Procedure (IPP) – Rescinded and replaced by Transmittal 494 |
01/06/2014 |
8284 |
| R474PI |
07/05/2013 |
Update to Chapter 15 of the Program Integrity Manual (PIM) |
10/08/2013 |
8341 |
| R471PI |
06/11/2013 |
Update to Chapter 15 of the Program Integrity Manual (PIM) |
05/28/2013 |
8222 |
| R470PI |
05/31/2013 |
Revision to Surety Bond Collection Process |
07/01/2013 |
8283 |
| R469PI |
05/31/2013 |
Enrollment Denials When an Existing or Delinquent Overpayment Exists – Rescinded and replaced by Transmittal 479 |
10/07/2013 |
8039 |
| R463PI |
05/17/2013 |
Model Letter Revisions |
06/07/2013 |
8117 |
| R462PI |
05/16/2013 |
Update to Chapter 15 of the Program Integrity Manual (PIM) |
03/18/2013 |
8155 |
| R461PI |
04/26/2013 |
Update to Chapter 15 of the Program Integrity Manual (PIM) – Rescinded and |
05/28/2013 |
8222 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
replaced by Transmittal 471 |
|
|
| R459PI |
04/12/2013 |
Tax Identification Numbers of Foreign Owning and Managing Entities and Individuals |
05/13/2013 |
8258 |
| R457PI |
04/02/2013 |
Model Letter Revisions – Rescinded and replaced by Transmittal 463 |
04/22/2013 |
8117 |
| R456PI |
03/22/2013 |
Model Letter Revisions – Rescinded and replaced by Transmittal 457 |
04/22/2013 |
8117 |
| R450PI |
02/15/2013 |
Update to Chapter 15 of the Program Integrity Manual (PIM) – Rescinded and replaced by Transmittal 462 |
03/18/2013 |
8155 |
| R445PI |
12/14/2012 |
Revision to Section 15.5.20 of Chapter 15 of the Program Integrity Manual (PIM) |
01/01/2014 |
7864 |
| R440PI |
11/23/2012 |
Revisions to Appeals Section of Chapter 15 of the Program Integrity Manual (PIM) |
12/24/2012 |
8110 |
| R437PI |
11/02/2012 |
Revision to Section 15.5.20 of Chapter 15 of the Program Integrity Manual (PIM) – Rescinded and replaced by Transmittal 445 |
02/01/2013 |
7864 |
| R435PI |
10/19/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part IX |
11/20/2012 |
8019 |
| R433PI |
09/07/2012 |
Review of Debarment List and Processing of Tie-in Notices |
10/09/2012 |
8020 |
| R431PI |
08/31/2012 |
Ordering and Certifying Documentation-Maintenance Requirements |
10/01/2012 |
7890 |
| R430PI |
09/28/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part VIII |
10/29/2012 |
7889 |
| R424PI |
06/13/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part VI |
06/19/2012 |
7827 |
| R423PI |
06/01/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part VII |
07/02/2012 |
7839 |
| R421PI |
05/18/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part VI – Rescinded and replaced by Transmittal 424 |
06/19/2012 |
7827 |
| R416PI |
04/13/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part III |
02/27/2012 |
7698 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
| R415PI |
04/13/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part V |
05/14/2012 |
7797 |
| R414PI |
04/06/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part IV |
05/07/2012 |
7763 |
| R412PI |
03/30/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part II |
04/30/2012 |
7646 |
| R410PI |
03/02/2012 |
Instructions for Processing Form CMS-855O Submissions |
06/04/2012 |
7723 |
| R408PI |
02/22/2012 |
Additional Provider and Supplier Enrollment Requirements for Fixed Wing and Helicopter Air Ambulance Operators |
02/03/2012 |
7363 |
| R407PI |
02/09/2012 |
Advanced Diagnostic Imaging (ADI) Accreditation Enrollment Procedures(This CR Fully Rescinds and Replaces CR 7177) |
01/27/2012 |
7681 |
| R405PI |
01/26/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM) –Part III – Rescinded and replaced by Transmittal 416 |
02/27/2012 |
7698 |
| R404PI |
01/20/2012 |
General Update to Chapter 15 of the Program Integrity Manual (PIM)-Part I |
04/22/2012 |
7579 |
| R403PI |
01/20/2012 |
Claims Against Surety Bonds for Suppliers of Durable Medicare Equipment, Prosthetics. Orthotics and Supplies (DMEPOS) |
02/21/2012 |
7167 |
| R402PI |
01/13/2012 |
Advanced Diagnostic Imaging (ADI) Accreditation Enrollment Procedures(This CR Fully Rescinds and Replaces CR 7177) – Rescinded and replaced by Transmittal 407 |
01/27/2012 |
7681 |
| R400PI |
11/21/2011 |
Additional Provider and Supplier Enrollment Requirements for Fixed Wing and Helicopter Air Ambulance Operators – Rescinded and replaced by Transmittal 408 |
02/03/2012 |
7363 |
| R394PI |
10/27/2011 |
Additional Provider and Supplier Enrollment Requirements for Fixed Wing and Helicopter Air Ambulance Operators – Rescinded and replaced by Transmittal 400 |
02/03/2012 |
7363 |
| R392PI |
10/14/2011 |
Update to Notifications Sent to State |
11/15/2011 |
7532 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
Medicaid Agencies and Child Health Plans of Medicare Terminations for Certified Providers and Suppliers and Medicare Revocations for Providers and Suppliers. This CR rescinds and fully replaces CR 7017, 7074 and 7334 |
|
|
| R388PI |
09/16/2011 |
Additional Review Activities for Home Health Agencies (HHAs) |
12/17/2011 |
7525 |
| R387PI |
09/01/2011 |
Eligible Physicians and Practitioners Who Need to Enroll in the Medicare Program for the Sole Purpose of Ordering and Referring Services for Medicare Beneficiaries |
10/18/2010 |
7097 |
| R380PI |
08/03/2011 |
Advanced Diagnostic Imaging Accreditation Enrollment Procedures |
07/05/2011 |
7177 |
| R374PI |
05/06/2011 |
Update to Notifications Sent to State Medicaid Agencies and Child Health Plans of Medicare Terminations for Certified Providers and Suppliers and Medicare Revocations for Providers and Suppliers |
06/06/2011 |
7334 |
| R373PI |
04/07/2011 |
Advanced Diagnostic Imaging Accreditation Enrollment Procedures – Rescinded and replaced by Transmittal 380 |
07/05/2011 |
7177 |
| R372PI |
03/25/2011 |
Effective Date of Certified Provider or Supplier Agreement or Approval |
04/25/2011 |
7232 |
| R371PI |
03/23/2011 |
Implementation of Provider Enrollment Provisions in CMS-6028-FC |
03/25/2011 |
7350 |
| R369PI |
03/11/2011 |
Advanced Diagnostic Imaging Accreditation Enrollment Procedures – Rescinded and replaced by Transmittal 373 |
06/12/2011 |
7177 |
| R365PI |
01/28/2011 |
Diabetes Self-Management Training (DSMT) |
04/29/2011 |
7236 |
| R363PI |
01/14/2011 |
Clarification for Part A Contractors Including Audit and Claims Intermediaries Notifying Each Other via E-mail Upon Processing of the Initial Enrollment Application, Change of Information, Voluntary Termination, or |
02/15/2011 |
7221 |
| Rev # |
Issue Date |
Subject |
Impl Date |
CR# |
|
|
Any Other CMS-855 Transaction |
|
|
| R358PI |
10/29/2010 |
Indian Health Service (IHS) Facilities and Tribal Provider's Use of Internet-based Provider Enrollment, Chain and Ownership System (PECOS) |
11/29/2010 |
7174 |
| R357PI |
10/01/2010 |
Durable Medical Equipment (DME MAC) and the National Supplier Clearinghouse (NSC MAC) Procedures for Third Party Notification of Deceased Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) Supplier Associates |
10/04/2010 |
6714 |
| R356PI |
09/24/2010 |
Manual Redesign |
10/26/2010 |
7083 |
| R355PI |
09/17/2010 |
Eligible Physicians and Practitioners Who Need to Enroll in the Medicare Program for the Sole Purpose of Ordering and Referring Services for Medicare Beneficiaries |
10/18/2010 |
7097 |
| R354PI |
08/27/2010 |
Manual Redesign |
09/28/2010 |
7016 |
| R353PI |
08/27/2010 |
Notification to State Medicaid Agencies and Child Health Plans of Medicare Terminations for Certified Providers and Suppliers |
09/28/2010 |
7074 |
| R350PI |
08/20/2010 |
Notification to State Medicaid Agencies and Child Health plans of Medicare Revocation |
09/21/2010 |
7017 |
| R347PI |
07/15/2010 |
Chapter 10 Manual Redesign - Initial release of Chapter 15 |
07/30/2010 |
6938 |
| R346PI |
06/25/2010 |
Guidance on Implementing Section 3109 of the Patient Protection and Affordable Care Act (PPACA) |
01/03/2011 |
7021 |
| R344PI |
06/18/2010 |
Chapter 10 Manual Redesign - Initial release of Chapter 15 - Rescinded and replaced by Transmittal 347 |
07/05/2011 |
6938 |
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