April 21, 2017

Providers and suppliers must use the revised CMS-588 form (Electronic Funds Transfer Authorization Agreement) beginning January 1, 2018. CMS will post the revised form on the CMS Forms List by early summer. Medicare Administrative Contractors will accept both the current and revised versions of the CMS-588 through December 31, 2017. Visit the Medicare Provider-Supplier Enrollment webpage for more information about Medicare enrollment and the Electronic Funds Transfer (EFT) requirements.

Changes to the form include:

  • New indicator shows if the EFT is for an individual or a group/organization/corporation in Parts 1 and 2 (Reason for Submission and Account Holder Information)
  • Now optional to list the financial institution's contact person
  • Four digits added to the "Provider's/Supplier's/Indirect Payment Procedure Entity's Account Number with Financial Institution," making it consistent with the industry standard