OMB control number
Medicare Participating Physician or Supplier Agreement (CMS-460)
OMB 0938-0373 · HHS/CMS.
OMB 0938-0373
The CMS-460 is completed by nonparticipating physicians and suppliers if they choose to participate in Medicare Part B. By signing the agreement, the physician or supplier agrees to take assignment on all Medicare claims. To take assignment means to accept the Medicare allowed amount as payment in full for the services they furnish and to charge the beneficiary no more than the deductible and coinsurance for the covered service. In exchange for signing the agreement, the physician or supplier receives a signficiant number of program benefits not available to nonparticipating suppliers. The information associated with this collection is needed to identify the recipients of the program benefits.
The latest form for Medicare Participating Physician or Supplier Agreement (CMS-460) expires 2028-12-31 and is listed under ICR 202507-0938-010.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-460 Medicare Participating Physician or Supplier Agreement Form | Form and Instruction |
| Form CMS-460 Medicare Participating Physician or Supplier Agreement | Form and Instruction |
 CMS-460.Supporting Statement Part A.docx | Supporting Statement A |
| CMS-460.Supporting Statement Part A.docx | Supporting Statement A |
 Medicare Participating Physician or Supplier Agreement |
Form and Instruction |
| Medicare Participating Physician or Supplier Agreement |
Form and Instruction |