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USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 518-3285
7:00 AM - 5:00 PM CT, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 234-7331
8:00 AM - 5:00 PM ET, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
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Electronic Provider Enrollment (Internet-Based PECOS)
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Providers can use the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) to enroll in the Medicare program, report changes to their Medicare enrollment information, and revalidate their Medicare enrollment.
Electronic enrollment offers several advantages. For example:
- Faster then paper-based enrollment
- Scenario-driven application process reduces staff time and administrative costs
- Scenario-driven application process reduces the chances that development will be required
While PECOS supports most Medicare enrollment application actions, there are some limitations. For example, a physician or non-physician practitioner cannot use PECOS to change his/her name or primary specialty.
Accessing PECOS
Before you can use PECOS, you must create an account in the CMS Identity & Access Management System. See the I&A Management System Quick Reference Guide for directions on how to create an account, set up Multi-Factor Authentication (MFA), and give others access to your PECOS account as a Surrogate.
After creating an account in the I&A Management System, you can login to PECOS.
If you experience login issues, for example, if you have forgotten your user name or have trouble creating a password, use the Help Tools available on the website. WPS GHA employees are not able to assist you with these issues.
Submitting Your Enrollment Application Fee in PECOS
An application fee is due for institutional providers that are:
- Initially enrolling in Medicare
- Revalidating their Medicare
- Adding a new practice location to their Medicare enrollment
CMS defines an “institutional provider” as any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A, CMS-855B (except physician and non-physician practitioner organizations), or CMS-855S application, or the associated PECOS enrollment application. Providers who are not sure if they need to pay a fee should review the CMS fee matrix on the CMS website.
The amount of the application fee varies from year to year, and the date the provider submits the application determines the amount due. You can locate the current application fee on the CMS website.
Institutional providers must pay the applicable application fee using the PECOS On-Line application fee tool.
- Providers should pay the application fee prior to completing and submitting their enrollment application.
- In PECOS, the confirmation screen is your receipt and should be printed for your records
- Upload the receipt to PECOS (see “Submit Supporting Documentation in PECOS” below).
The application fee, paid electronically by check, debit card, or credit card, is processed through PECOS to CMS under the U.S. Department of the Treasury. The following credit cards are accepted: Visa, MasterCard, American Express, and Discover.
If you experience issues submitting your payment, use the Help Tools available on the Pay.gov website. WPS GHA employees are not able to assist you with these issues.
Enter or Update Enrollment Information in PECOS
PECOS provides a scenario-driven application process. You will be prompted to enter only information needed to complete your task (e.g. initial enrollment, change of address, revalidation).
To start an initial enrollment application in PECOS:
- Select the “MY ENROLLMENTS” button or the “MY ASSOCIATES” button.
- Select the “NEW APPLICATIONS” button or the “CREATE INITIAL ENROLLMENT APPLICATION” button.
- Choose the radio button for the Individual or Organization you are creating the application for and select the “NEXT PAGE” button.
- Select the Option that best represents the healthcare service rendered for this application and select the “NEXT PAGE” button.
- Institutional Provider (Part A – 855A)
- Clinic/Group Practice and Certain Other Suppliers (Part B – 855B)
- DME (855S)
- MDPP
- Individual Physician or Non-Physician Practitioner (Part B – 855I/855R) (please note, this option does not appear if you have selected an Organization)
- Eligible Ordering, Certifying, and Prescribing Physicians and Other Eligible Professionals (Part B – 855O) (please note, this option does not appear if you have selected an Organization)
- If you selected Institutional Provider
- Select the State/Territory where the applicant renders Healthcare Services and hit “NEXT PAGE”
- Select the Primary Specialty of the Provider and hit “NEXT PAGE”
- Answer Yes or No to the Change of Ownership question: “Is the facility where the services are provided currently enrolled under a different tax identification number?” Then hit “NEXT PAGE”
- If you selected Clinic/Group Practice and Certain Other Suppliers (Part B – 855B)
- Select the State/Territory where the applicant renders Healthcare Services and hit “NEXT PAGE”
- Select the Primary Specialty of the Provider and hit “NEXT PAGE”
- Answer if the applicant is an Indian Health Services (IHS) Facility and hit “NEXT PAGE”
- Review informational page regarding submitting Individual Reassigning Benefits
- If you selected Individual Physician or Non-Physician Practitioner (Part B – 855I/855R)
- Select the option that best matches your situation:
- Sole Owner of a PA, PC or LLC
- Self-Employed/Sole Proprietor
- Group Member Only
- Group Member and is Self-Employed
- Disregarded Entity
- Verify personal information and hit “NEXT PAGE”
- Select the State/Territory where the applicant renders healthcare services and hit “NEXT PAGE”
- Select the Primary Physician or Non-Physician Specialty and hit “NEXT PAGE”
- If you selected Sole Owner, PECOS will prompt you to pick the Supplier’s specialty (Clinic/Group Practice or Physical/Occupational Therapy Group in Private Practice).
- If you selected Sole Owner, PECOS will ask you if it is an IHS Facility. Answer yes or no, then hit “NEXT PAGE”
- If you selected Sole Owner, enter the legal business name (LBN) and tax identification number (TIN) and hit “NEXT PAGE”
- If you selected Group Member Only, you will receive a notification that the entity receiving benefits must also be enrolled if joining a group. Answer yes or no to the question “Would you like to Continue?” and then hit “NEXT PAGE”
- If you selected Self-Employed/Sole Proprietor, PECOS will ask you if the applicant wants payments reported under a tax identification number (TIN). Enter the effective date of ownership and the telephone number and then hit “NEXT PAGE”
- If you selected Self-Employed/Sole Proprietor, PECOS will ask you “Is the applicant employed by a business or individual that will receive the practitioner’s Medicare claims payments? Answer yes or no and hit “NEXT PAGE”
- Select the option that best matches your situation:
- If you selected Eligible Ordering, Certifying, and Prescribing Physicians and Other Eligible Professionals (Part B – 855O)
- You will be navigated to the Easy Enrollment Process to complete your 855O application
- Converting 855I (or Opt Out Affidavit) to 855O - If there are any existing Medicare Enrollments or Affidavits it will ask if you would like to convert them to an 855O.
- Verify the information is correct, and scroll down to select the “START APPLICATON” button.
- The Topic View page will open, and each item must be complete before submitting the application. To complete a section, select the hyperlink for the section.
To start a change of information application in PECOS:
- Select the “MY ASSOCIATES” button.
- Select the “VIEW ENROLLMENTS” button next to the Individual or Organization submitting a change of information.
- Scroll down and select the “MORE OPTIONS” button by the provider who is changing information.
- Select “Perform a Change of Information to Current Enrollment Information.”
- Select the “NEXT PAGE” button.
- Select an Option:
- Option 1 – adding a practice location in a different state/territory and/or you are adding/changing your primary specialty/provider type
- Choosing this Option will create a new application
- Option 2 – adding/updating a practice location in the same state/territory and/or updating reassignment information and/or making other changes to existing enrollment information
- Choosing this Option will update the current enrollment.
- Option 1 – adding a practice location in a different state/territory and/or you are adding/changing your primary specialty/provider type
- Select the “NEXT PAGE” button.
- Respond to question about additional changes: making updates to the enrollment or only need to make Reassignment Updates
- Select the “NEXT PAGE” button
- Verify the information is accurate and the submittal reason is appropriate, then select the “START APPLICATION” button.
- Select the “Topic View” tab.
- Select the hyperlink for the information you are updating.
To start a revalidation application
- Select the “MY ASSOCIATES” button.
- Select the “VIEW ENROLLMENTS” button.
- Scroll down and select the “REVALIDATE” button by the provider who is revalidating.
- Select “Start Application” and begin navigating through the topics that require updating.
If you receive a system-error message while completing your application, contact External User Services (EUS) at (866) 484-8049. WPS GHA employees are not able to assist you with these issues.
If you need help entering or updating information in PECOS, please review the training videos found under PECOS Resources and Training below.
Submit Supporting Documentation in PECOS
PECOS allows providers to upload supporting documentation. We encourage all users to upload supporting documentation with their application to avoid receiving a development request. If a provider choses to submit documentation by fax or email, they must include the web application Tracking ID on all supporting documents.
To upload documentation in PECOS:
- From the Topic View tab, select “Required and/or Supporting Documentation.”
- Select “Yes” to the following question: Does the applicant wish to upload supporting documentation?
- Select the document type.
- Browse your computer for the file.
- The file must be either PDF or TIFF formatted and 10MB or less
- Select the file and hit “UPLOAD”
- View the file to be sure the upload completed correctly.
- If the file did not upload correctly, remove the file and try again.
For step-by-step directions, with screen shots, on how to upload a document to PECOS see the Digital Document Repository How to Guide .
If you receive a system-error message while uploading your documentation, if you experience issues printing your documentation, or if you need to reprint a Security Consent Form, contact External User Services (EUS) at (866) 484-8049. WPS GHA employees are not able to assist you with these issues.
Submitting Your Application in PECOS
After entering or updating your enrollment information and submitting supporting documentation, you are ready to begin the submission process.
During this process, the system will check your application for errors. If the system finds no errors, you will be required to select your Medicare contractor and mail or upload any forms required for your application. The next step is to select a signature method for each signer. You can select E-Sign (Sign Now if available) or Upload; then select ”NEXT PAGE.”
Finally, you will select “Complete Submission” to send your application to your MAC for processing.
After submitting your application, PECOS provides a Submission Receipt. This receipt confirms submission to your MAC and includes a Tracking ID. The Tracking ID is a way to communicate the application submission being successfully sent to the MAC.
Electronic Signature in PECOS
After you submit your PECOS enrollment, the system will send an email to the authorized signer(s).
The email includes a unique PIN and two options to sign the application, sign with a PECOS User ID or use the PECOS E-Signature website. The unique PIN is required to use the PECOS E-Signature website.
- The user completing the application must provide an email address for the authorized signer(s) of the application as part of the submission process. The system generates an email to the authorized signer(s) who must follow the instructions in the email to sign the application electronically.
- The user enrolling as an individual professional, not including new reassignment, may sign electronically as part of the submission process.
- The user enrolling as an ordering/referring provider may sign electronically as part of the submission process.
- When submitting a new reassignment of benefits, either alone or with another application, select the authorized or delegated official for the organization accepting the reassignment and provide that official's email address. The system generates an email to the authorized signer(s), who must follow the instructions in the email to sign the application electronically.
- As part of the submission process, the user completing an organizational application must provide an email address for the authorized signer(s) of the application. The system generates an email to the authorized signer(s), requiring them to follow the instructions in the email to sign the application electronically.
Checking the Status of Your Enrollment Application in PECOS
To check the status of your enrollment application, log in to PECOS and select “My Associates.” Then select “View Enrollment” by the NPI or TIN for which you want to check status. Scroll down to Existing Enrollment to view the status of your application.
Responding to Development Requests in PECOS
If we require additional information to process your application, we will send an email to the contact person with details regarding the information needed and a deadline for submitting that information. The email will be sent from customerservice-donotreply@cms.hhs.gov. To ensure receipt of development emails, the contact person should add customerservice-donotreply@cms.hhs.gov to their safe senders list. They should also routinely check their email inbox, spam, and junk folders for development requests.
To avoid delays in processing your application, log in to PECOS as soon as possible to make necessary corrections and/or upload required documents.
PECOS Resources and Training
Identity & Access System Quick Reference Guide
Instructions for Viewing Physician and Non-Physician Practitioner Status and Specialty Type in PECOS
Internet-based PECOS -- Enrollment Example
MM10845 Update to Chapter 15, Pub. 100-08 Certification Statement Policies
Windows Media Video (.wmv) Files:
PECOS Enrollment Example Webinar - Sole Proprietor
PECOS Enrollment Example Webinar - Sole Owner
PECOS Enrollment Example Webinar - Change of Information
PECOS Enrollment Example Webinar - Reassignment of Benefits
PECOS Enrollment Example Webinar - Two Directors
CMS YouTube Videos:
Individual Provider
Organization/Supplier
For additional resources, visit the CMS Internet-based PECOS website.
WPS GHA offers training for Internet-based PECOS on our YouTube Channel .
global-tags: Featured Guides and Resources,J8A,J5A,Provider Enrollment,J8B,J5B,Electronic Provider Enrollment
Need help?
Contact Us About Provider Enrollment
(866) 518-3285
7:00 AM - 5:00 PM CT, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 234-7331
8:00 AM - 5:00 PM ET, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 518-3285
7:00 AM - 5:00 PM CT, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
(866) 234-7331
8:00 AM - 5:00 PM ET, Monday - Friday
USPS Mailing Address
WPS GHA
Medicare Provider Enrollment
P.O. Box 8248
Madison, WI 53708-8248
Overnight Delivery
WPS GHA
Medicare Provider Enrollment
1717 W. Broadway
Madison, WI 53713-1834
.
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- Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
- Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association web site, http://www.ADA.org/.
- Applicable Federal Acquisition Regulation Clauses (FARS)\Department of restrictions apply to Government Use. Please click here to see all U.S. Government Rights Provisions.
- ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. CDT IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES O F MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. NO FEE SCHEDULES, BASIC UNIT, RELATIVE VALUES OR RELATED LISTINGS ARE INCLUDED IN CDT. THE ADA DOES NOT DIRECTLY OR INDIRECTLY PRACTICE MEDICINE OR DISPENSE DENTAL SERVICES. THE SOLE RESPONSIBILITY FOR THE SOFTWARE, INCLUDING ANY CDT AND OTHER CONTENT CONTAINED THEREIN, IS WITH (INSERT NAME OF APPLICABLE ENTITY) OR THE CMS; AND NO ENDORSEMENT BY THE ADA IS INTENDED OR IMPLIED. THE ADA EXPRESSLY DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY ATTRIBUTABLE TO OR RELATED TO ANY USE, NON-USE, OR INTERPRETATION OF INFORMATION CONTAINED OR NOT CONTAINED IN THIS FILE/PRODUCT. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. The ADA is a third party beneficiary to this Agreement.
- CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. IN NO EVENT SHALL CMS BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL.