Crosswalk of Changes

CMS-855S - Crosswalk of Changes.xlsx

Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers (Form 855S)

Crosswalk of Changes

OMB: 0938-1056

Document [xlsx]
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Section Number Revision Justification
Entire 855S National Supplier Clearinghouse/the National Supplier Clearinghouse Medicare Admininistrative Contractor (NSC MAC)/NSC MAC replaced with contractor/your contractor/Your National Provider Enrollment DMEPOS contractor DME National Provider Enrollment (NPE) contract awarded to two contractors, Novitas (Eastern Region) and Palmetto (Western Region) with a cutover date of 11/07/2022.
Entire 855S Website "https://palmettogba.com/nsc" changed to "https://www.novitas-solutions.com or https://www.palmettogba.com/palmetto/npewest.nsf" Update due to contractor change.
INSTRUCTION PAGES Acronym description changed from "NSC MAC: National Supplier Clearinghouse Medicare Administrative Contractor" to the following two acronym descriptions "NPEAST (Novitas Solutions): National Provider Enrollment Eastern Region DMEPOS Contractor" and "NPWEST (Palmetto GBA): National Provider Enrollment Western Region DMEPOS Contractor" Update due to contractor change.
INSTRUCTION PAGES "The NSC MAC is responsible for processing your enrollment application. Mail this application to:" changed to "Novitas Solutions (NPEAST) or Palmetto GBA (NPWEST) is responsible for processing your enrollment application based on your geographic location:
Novitas Solutions: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands
Palmetto GBA: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands
Mail this application to your designated contractor.
For Palmetto GBA, mail this application to:"
Update due to contractor change.
INSTRUCTION PAGES "National Supplier Clearinghouse
Post Office Box 100142
Columbia, SC 29202-3142" Changed to "Palmetto GBA
NPWEST DMEPOS
PO Box 100142
Columbia, SC 29202-3142"
Address change due to contractor change.
INSTRUCTION PAGES "National Supplier Clearinghouse" changed to "National Provider Enrollment West" Update due to contractor change.
INSTRUCTION PAGES Additional mailing information added : "For Novitas Solutions, mail this application to:", "Novitas Solutions
NPEAST DMEPOS
PO Box 3704
Mechanicsburg, PA 17050", "Overnight Mailing Address:
Novitas Solutions
National Provider Enrollment East
2020 Technology Parkway, Suite 100
Mechanicsburg, PA 17050" , "Customer Service for NPE East: 1-866-520-5193
Web: https://www.novitas-solutions.com"
Update due to contractor change, additional contractor information added.
2D Changed "The NSC MAC website at palmettogba.com/nsc" to "The contractors’ websites at https://www.novitas-solutions.com
or https://www.palmettogba.com/palmetto/npewest.nsf"
Update due to contractor change and new information.
2E2 Added "Chiropractor" as an option for type of supplier. Error correction - previously omitted.
2E2 Added checkboxes to collect information regarding the following accreditation exemption reasons: "The supplier is exempt from DMEPOS accreditation based on supplier type; The supplier location is previously enrolled pharmacy with attestation on file; or The supplier is a pharmacy providing only non-accredited products." NSC MAC asked that this section be added for better supplier instruction to reduce development.
2E4 Changed "The NSC MAC website at palmettogba.com/nsc" to "The contractors’ websites at https://www.novitas-solutions.com
or https://www.palmettogba.com/palmetto/npewest.nsf"
Update due to contractor change and new information.
2E4 Additional product added to section 2E4, in a new row, on the existing table as follows: Lymphedema Compression Treatment Items Update to products covered.
7A Removed "as shown below" and "National Supplier Clearinghouse
Post Office Box 100142
Columbia, SC 29202-3142"
Due to contractor change and all contact information being located in the instructions pages.
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