Medicare EDI Enrollment Form and EDI Registration (CMS-10164 A/B)

Federal law requires that CMS minimize the security risk to federal information systems. CMS is requiring that trading partners who wish to conduct the Electronic Data Interchange (EDI) transactions provide certain assurance as a condition of receiving access to the Medicare system for the purpose of conducting EDI exchanges. Health care providers, clearinghouses, and health plans that wish access to the Medicare system are required to complete this form. The information will be used to assure that those entities that access the Medicare system are aware of applicable provisions and penalties.

The latest form for Medicare EDI Enrollment Form and EDI Registration (CMS-10164 A/B) expires 2022-03-31 and can be found here.