If you are not currently a Medicare provider, you will need to apply for an NSC number before signing up for CareCLAIM. For your convenience we have already completed the section regarding Billing Agency information in the CMS 855S Application Form.

Please be aware that you must have your NPI (National Provider Identification) before completing the CMS 855 Application Form. If you do not have one, click here to apply online or download the pdf file and mail in your application.

The CMS 855B Application form will need to be completed if you wish to conduct a massimmunization clinic. Mail the completed form to the Medicare Area Contractor for your location - click here to find your contractors address

	CMS 855S Application Form
	CMS 855B Application Form