Updated April 25, 2020

As part of the distribution of the remaining $70 billion in funds (CARES Act Provider Relief Fund), Health and Human Services (HHS) is asking providers who have already received payments from the initial distribution of $30 billion to supply information from IRS tax filings and to supply estimates of lost revenues in March and April of 2020, if they wish to be eligible to receive additional funds. HHS will be distributing an additional $20 billion to these providers.

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Any person authorized by the provider organization may complete the HHS form. HHS would recommend that it be completed by an organization’s chief financial officer (CFO) or accounting professional.

Have the following information on hand before you begin:

  • Taxpayer Identification Number (TIN) that has received prior Provider Relief Fund payments.
  • TINs of subsidiary organizations that have received prior Provider Relief Funds but do not file separate tax forms (i.e., subsidiary organizations that are accounted for in the parent organization’s tax filing). 
  • The portal’s customer service line responded that anyone with a billing TIN (including pediatricians and gynecologists) should complete the application.
  • Amount of payments received.
  • Lost March 2020 revenues.
  • Estimated lost April 2020 revenues.
  • Relief Fund payment transaction numbers / check numbers.
  • A copy of your most recently filed tax forms — Download Appendix A: Federal Tax Classification Matrix (will need to upload these forms in the application).

For additional information, recipients should visit hhs.gov/providerrelief or call the CARES Provider Relief line at (866) 569-3522. To learn more about the General Distribution/Provider Relief Portal, read the HHS's frequently asked questions.

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