{"data":{"id":"us/42-cfr-424.505","jurisdiction":"us","citation":"42 CFR 424.505","heading":"Basic enrollment requirement.","body":"To receive payment for covered Medicare items or services from either Medicare (in the case of an assigned claim) or a Medicare beneficiary (in the case of an unassigned claim), a provider or supplier must be enrolled in the Medicare program. Except for those suppliers that complete the CMS-855O form or CMS-identified equivalent, successor form or process for the sole purpose of obtaining eligibility to order or certify Medicare-covered items and services; once enrolled the provider or supplier receives billing privileges and is issued a valid billing number effective for the date a claim was submitted for an item that was furnished or a service that was rendered. (See 45 CFR part 162 for information on the National Provider Identifier and its use as the Medicare billing number.)","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 424—CONDITIONS FOR MEDICARE PAYMENT","Subpart P—Requirements for Establishing and Maintaining Medicare Billing Privileges"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"25b70c9a4184519c20d63611b0af2d3afe0bccc32e1f41114788596d4c8cbc9b","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-424.502","next":"us/42-cfr-424.506"},"notice":"GroundRules: Original legal text. Not legal advice."}