Request for electronic funds transfer (EFT) form

If you are currently not receiving Medicare payments via electronic funds transfer (EFT), please be on the lookout for a letter dated April 25, 2024, from Novitas/NPEAST requesting submission of a CMS-588 EFT form.  In accordance with 42 CFR 424.510(e)(1), and Pub 100-08, Chapter 10, Section 10.6.10 of the Internet-Only Manuals, all providers and suppliers are required to receive payments via electronic funds transfer.  Please follow the instructions in the letter by downloading and completing the current version of the paper EFT form and attaching a copy of the April 25, 2024, letter for easier identification.   Also, to avoid development, please include a voided check or a letter from the bank verifying the account information.  If an EFT form is not submitted by the due date of July 24, 2024, your Medicare billing privileges will be deactivated.

The form and attachments can be uploaded into our Enrollment Gateway at: EnrollmentGateway (novitas-solutions.com) or mailed to: 

Novitas Solutions, Inc.

NPEAST DMEPOS

PO Box 3704

Mechanicsburg, PA 17055-1863