If you thought $569 was a hefty application fee for Medicare enrollment for institutional providers in 2018, get ready for another shock. CMS raised the cost to $586 for Calendar Year 2019. “Using [Bureau of Labor Statistics] BLS data, the [Consumer Price Index for Urban Areas] CPI-U increase for the period of July 1, 2017 through June 30, 2018 was 2.9 percent,” said the CMS notice. “This results in a CY 2019 application fee amount of $585.501 ($569 x 1.029). As we must round this to the nearest whole dollar amount, the resultant application fee for CY 2019 is $586.00.” The agency estimates that the increase will impact about “54,450 institutional providers,” according to the notice. The $17 increase marks the biggest one-year jump since CMS started posting the data in 2011. If you file for enrollment using forms “CMS-855A, CMS-855B (not including physician and non-physician practitioner organizations), CMS-855S, CMS-20134, or associated Internet based PECOS enrollment application,” you are slated to feel that $17 bump, advises CMS. See the CMS notice in the Federal Register at https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-25012.pdf.