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Practice Manager Form

Medicare Participation Agreement (CMS-460)

A downloadable Practice Manager form for healthcare professionals.
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About this form

The Medicare Participation Agreement (CMS-460) is used to enroll as participating providers in Medicare Part B. By signing this agreement, the provider agrees to accept assignment for all covered Part B services, meaning Medicare-approved amounts are accepted as full payment, subject only to applicable deductibles and coinsurance. The form captures provider or supplier identifiers, National Provider Identifier (NPI), and agreement details required to establish or maintain Medicare participation. Completing this form in Heidi streamlines your administrative processes and assists practices in managing Medicare participation records.

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How to use this form

1

Download the PDF

Click the download button to save the form to your device

2

Print or fill digitally

Print the form for handwritten use or fill it out using a PDF editor

3

Use in your practice

Integrate the completed form into your patient records and workflows

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Specialty

Practice Manager

Downloads

1 times

Type

Form

Last edited

26.1.2026

Created by

Heidi Team

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