Medicare (PECOS) Provider Credentialing & Enrollment
Which Medicare Enrollment Application Applies?
CMS-855I covers individual practitioner enrollment and paper reassignment actions. Complete the reassignment in PECOS if a group will bill for your services. A group practice generally uses CMS-855B for its organization record. Confirm each clinician’s enrollment, reassignment and practice location before the group bills.
Original Medicare Enrollment Preflight
- Use CMS’s application instructions to gather the supporting documents that apply to your provider type, ownership, practice locations and banking information.
- Verify who can sign and which contractor covers your provider type and service location.
- Review electronic funds transfer and revalidation requirements for your filing.
- CMS PECOS and enrollment applications
- CMS revalidation due dates and requirements
What Changes by Provider Type?
Institutional providers and durable medical equipment suppliers use different applications. If you only order or certify for Medicare, verify the separate ordering and certifying enrollment path. Medicare Advantage participation follows the plan’s own requirements. CMS Medicare Advantage Preclusion List guidance.
What to Verify Before Submitting
Check the NPI, legal business name, sites, authorized signer and billing relationship against your records. For group billing, verify the reassignment and site details before handing the record to your billing team.
What ProEnrollment Handles
ProEnrollment LLC can help select the applicable filing, prepare supporting records and track requests and approvals from your contractor.
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Get Help With Your Medicare Filing
Share your provider type, practice locations, target insurance products and planned start date. Request a credentialing consultation.