PECOS and Medicare Enrollment Frequently Asked Questions

PECOS stands for Provider Enrollment, Chain, and Ownership System. It is the online system CMS uses to manage Medicare enrollment for providers and suppliers. A provider must be enrolled in Medicare through PECOS before they can bill Medicare and receive payment. PECOS is available at pecos.cms.hhs.gov.

Read the full PECOS guide.

No. They are separate systems that serve different purposes and do not sync with each other.

• NPPES assigns NPIs and manages the public provider registry.
• PECOS manages Medicare enrollment records.

Both use the same I&A System login credentials. However, updating your address or other information in NPPES does not update your PECOS enrollment record. Both systems must be updated separately when information changes.

All Medicare Fee-for-Service providers and suppliers can use PECOS to enroll, update, or revalidate their enrollment. PECOS is available 24 hours a day, Monday through Saturday, with scheduled downtime on Sundays. Technical support is available daily from 5 am to 8 pm Central Time.

PECOS is strongly encouraged but not mandatory. You may submit the appropriate paper CMS-855 form instead. Even if you apply on paper, your MAC enters the data into PECOS, so a PECOS record is created either way. Paper submissions take longer to process.

If submitting a paper application, mail it to the correct address for your provider type. Parts A and B providers mail to their regional MAC. DMEPOS suppliers mail to the NPE DMEPOS contractor. Home health and hospice providers mail to the Home Health and Hospice Contractor.

You need an I&A System user ID and password. The I&A System is the shared login gateway for NPPES, PECOS, and several other CMS provider systems. Create your account at nppes.cms.hhs.gov/IAWeb.

Organizational providers and suppliers must also designate an Authorized Official (AO) through the I&A System before anyone can work in PECOS on the organization's behalf. Individual providers do not need an AO but can authorize Surrogates and Staff End Users to work in PECOS on their behalf.

Before logging in, gather all required information because PECOS times out after 15 minutes of inactivity. At a minimum you will need:

• An active NPI (required before enrollment can begin)
• An I&A System user ID and password
• Personal identifying information: legal name, date of birth, SSN (individuals)
• Professional license information: number, effective date, renewal date, state
• Specialty and, if applicable, board certification
• Practice location address
• EFT banking details: voided check or bank letter
• Any final adverse actions, if applicable

Organizations additionally need their Legal Business Name as filed with the IRS, their EIN, business structure and incorporation details, and information about their Authorized Official.

See the full enrollment guide with provider-type checklists.

After electronic submission, PECOS displays a Submission Confirmation page showing which MAC is processing your application and your unique application tracking number. PECOS also emails the web tracking ID to the Contact Person listed in the application.

You can check application status at any time by logging into PECOS and selecting View Enrollments, or by using the Application Status link on the PECOS home page without logging in.

Individual physicians, non-physician practitioners, and their organizations pay no enrollment fee. The $750 application fee (2026) applies to institutional providers and suppliers who submit forms CMS-855A, CMS-855B (except physician and NPP organizations), or CMS-855S. This includes hospitals, skilled nursing facilities, DMEPOS suppliers, and similar entities.

The fee applies when enrolling for the first time, revalidating, or adding a new practice location. A hardship exception may be requested in writing.

CMS conducts unannounced site visits through National Site Visit Contractors (NSVCs) as part of enrollment screening. Visits may be observational (inspector photographs the location with minimal contact) or detailed (inspector enters the facility and speaks with staff). Inspectors carry a photo ID and a CMS-issued authorization letter; staff may ask to see both.

If an inspector cannot complete a site visit, CMS may deny the enrollment application or revoke existing billing privileges. Make staff aware that site visits can occur without advance notice at any time during or after the enrollment process.

Participating providers accept Medicare assignment on all claims, agree to accept the Medicare-approved amount as full payment, and receive 5% higher reimbursement. Medicare forwards claim information to Medigap insurers automatically. To participate, submit the CMS-460 within 90 days of enrollment approval.

Non-participating providers may accept assignment on a case-by-case basis. They receive 5% less than the participating rate and cannot charge patients more than 115% of the Medicare Physician Fee Schedule amount (the limiting charge).

Participation status can only be changed during the annual open enrollment period, generally mid-November through December 31 each year.

Yes, for eligible providers. Physicians and certain eligible practitioners may opt out of Medicare by filing an opt-out affidavit with their MAC. An opted-out provider can charge patients any amount for covered services, but Medicare will not pay any portion of the cost and patients cannot be reimbursed by Medicare.

Opt-out periods last two years and renew automatically every two years unless terminated. A first-time opt-out can be terminated within 90 days of its effective date.

Note: even opted-out providers are listed on the CMS Opt Out Affidavits public dataset and may be eligible to order and refer Medicare items or certify services in certain circumstances. Opt-out status is visible on NPI Profile provider pages through our PECOS lookup integration. NPI Profile's PECOS enrollment data was last updated on June 04, 2026 and is refreshed weekly.

Three types of changes require the paper CMS-855 form and cannot be done through PECOS:

• Changing your Social Security Number
• Changing a provider's or supplier's Tax Identification Number (TIN)
• Changing an existing business structure (for example, converting from an LLC to a sole proprietorship, or vice versa)

All other changes can typically be made through PECOS. If you submitted your original enrollment on paper, you may still make subsequent changes online through PECOS.

Reporting timelines depend on provider type and the nature of the change:

• Physicians and NPPs: changes of ownership, practice location, and adverse legal actions within 30 days; all other changes within 90 days.
• DMEPOS suppliers: all changes within 30 days, with no 90-day option.
• Independent diagnostic testing facilities: ownership, location, supervision, and adverse legal actions within 30 days; all others within 90 days.
• MDPP suppliers: ownership, coach roster, and adverse legal actions within 30 days; all others within 90 days.

Search the Medicare Revalidation List at data.cms.gov/tools/medicare-revalidation-list by your name or NPI. Due dates are posted up to seven months in advance. If your due date shows as TBD, it is more than seven months away and you should not submit a revalidation yet.

Your MAC will also send a revalidation notice 90 to 120 days before your due date by email or postal mail. Even if you have not received a notice, you are responsible for tracking your own due date.

If you submit your revalidation after the due date, your MAC may place a hold on your Medicare payments or deactivate your billing privileges. There are no extensions and no exemptions from revalidation.

If your billing privileges are deactivated, you must submit a complete new Medicare enrollment application to reactivate them. Medicare will not reimburse services provided during the deactivation period, even after you re-enroll. That lost revenue cannot be recovered.

Read the full Medicare revalidation guide.

Only if you are within three months of a due date listed on the Medicare Revalidation List. In that case, submit your revalidation even without a MAC notice.

If no due date appears on the Revalidation List and you have not received a MAC notice, do not submit. Early unsolicited revalidations submitted more than seven months before the due date will be returned by your MAC without processing.

No. Through PECOS, you review information already on file and update only what has changed. You only need to complete sections relevant to your enrollment type. PECOS is fully paperless for revalidations, including electronic signature.

Yes. To bill Medicare for telehealth services, you must be enrolled in Medicare through PECOS just as you would for any other patient care service. There is no separate telehealth enrollment category; standard enrollment covers telehealth billing.

In most cases, no. Practitioners who furnish telehealth services from home but have a physical practice location are not required to report their home address on their Medicare enrollment application. They can enroll and bill from their physical practice location as if the telehealth service was furnished in person.

The exception is virtual-only practitioners whose only physical location is their home. Those practitioners must enroll their home address as a practice location. They should mark the address as a "Home office for administrative/telehealth use only" location in PECOS, which will suppress the street address details from public-facing CMS provider pages.

Yes, through December 31, 2027, Medicare beneficiaries may continue to receive audio-only telehealth services in their homes. Starting January 1, 2028, audio-only will be permitted only for behavioral health services furnished to patients in their home, and only when the practitioner is technically capable of using audio-video technology but the beneficiary is unable or unwilling to use it.

Non-face-to-face services such as Chronic Care Management, Remote Monitoring, and similar care management services are not subject to telehealth restrictions and do not require being on the Medicare Telehealth Services List.

NPI Profile's PECOS enrollment data was last updated on June 04, 2026. We refresh both NPPES and PECOS data weekly, sourced directly from CMS public datasets.

The PECOS enrollment status displayed on each provider profile, including Medicare participation, ordering and referring eligibility, opt-out status, and PECOS Associate Control ID, reflects the most recent weekly snapshot. For real-time verification, particularly for claims in process or time-sensitive credentialing decisions, query the CMS Order and Referring dataset or log into PECOS directly.

Use our PECOS Lookup tool to check a provider's current enrollment status as reflected in our latest data update.

The right contact depends on whether your issue is technical or enrollment-related:

Issue type	Who to contact
Can't access PECOS, system errors, printing problems	CMS External User Services (EUS) Help Desk: 1-866-484-8049 (TTY 1-866-523-4759), Mon-Fri 7 am to 7 pm ET
Forgotten I&A user ID or password	I&A System at nppes.cms.hhs.gov/IAWeb, or call EUS
Questions about enrollment requirements or documents	Your Medicare Administrative Contractor (MAC)
Revalidation questions	Your MAC for enrollment specifics; EUS for PECOS technical access
Application fee / Pay.gov issues	Your MAC
Not sure who to call	CMS Provider Enrollment Assistance Guide at cms.gov

Your MAC is determined by your practice location and provider type. CMS publishes the Medicare Fee-for-Service Provider Enrollment Contact List at cms.gov, which maps provider types and states to the correct MAC or specialty contractor. DMEPOS suppliers use the NPE DMEPOS East or West contractor rather than a standard MAC.

If you do not know which MAC handles your enrollment, consult the CMS Provider Enrollment Assistance Guide, which routes common questions to the correct CMS resource.