EFT is a form of direct deposit that allows the transfer of Medicare payments directly from a Medicare contractor’s bank to a provider’s bank account. CMS requires that all providers enrolling or changing existing enrollment information must use EFT.

Effective December 1, 2006, Medicare Contractors can only accept the 588 FORM CMS EFT 08/06 version of the Authorization Agreement for Electronic Funds Transfer. This form can be downloaded from the CMS Web site (http://www.cms.hhs.gov/cmsforms/downloads/CMS588.pdf ). The form must be complete, accurate, and include the original signature of the authorized/delegated official as well as the signature date.

Mail the completed CMS 588 Form to:

First Coast Service Options
PO Box 44021
Jacksonville Florida 32231-4021

Complete and accurate applications will usually be processed within 45 – 60 days. You will receive a confirmation letter when all processing has been completed. If you submitted your application more than 60 days ago, or have a general question about EFT agreements, you can call the appropriate number below to request a status:

A group does not need to submit an EFT form for each of its members. Only the group submits the form and indicates the group PIN and NPI if issued.

For more information, refer to our EFT tutorial.