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CMS-849. U.S. Federal Form: HHS-CMS: CMS-849. HHS-CMS. Agency Forms Management Officer. HHS-CMS. PDF. (1) USA-Federal-Forms.com, (2) Fillable.
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The CMS-849 form is a U.S. federal form used for reporting Medicare credit balance refunds.
Healthcare providers who have Medicare credit balance refunds are required to file CMS-849 form.
To fill out CMS-849 form, healthcare providers need to provide information about the Medicare credit balance refunds they are reporting.
The purpose of CMS-849 form is to report and return Medicare credit balance refunds to the appropriate Medicare provider.
Information such as provider name, address, Medicare identification number, refund amount, and reason for refund must be reported on CMS-849 form.
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