Accept assignment - Field 27 of cms 1500

Item 27

Check the appropriate block to indicate whether the provider of service or supplier accepts assignment of Medicare benefits. If Medigap is indicated in item 9 and Medigap payment
authorization is given in item 13, the provider of service or supplier shall also be a Medicare
participating provider of service or supplier and must accept assignment of Medicare
benefits for all covered charges for all patients.

The following providers of service/suppliers and claims can only be paid on
assignment basis:

• Clinical diagnostic laboratory services;
• Physician services to individuals dually entitled to Medicare and Medicaid;
• Participating physician/supplier services;
• Services of physician assistants, nurse practitioners, clinical nurse specialists, nurse midwives,
certified registered nurse anesthetists, clinical psychologists, and clinical social workers;
• Ambulatory surgical center services for covered ASC procedures;
• Home dialysis supplies and equipment paid under Method II;
• Ambulance services;
• Drugs and biologicals and
• Simplified billing roster for influenza virus vaccine and pneumococcal vaccine