PECOS

Understand what PECOS is, why it matters for Medicare enrollment, and how providers and practices can use it to manage their enrollment records accurately.

What is PECOS?

PECOS, short for the Provider Enrollment, Chain, and Ownership System, is the official online system used by the Centers for Medicare & Medicaid Services (CMS) to manage Medicare enrollment. If your practice plans to bill Medicare, PECOS is where it all starts.

Why Do Providers Need to Use PECOS?

Enrolling in Medicare isn’t just about filling out a few forms—it’s a regulated process that requires proper verification and documentation. PECOS serves as the digital gateway for:

• New Medicare provider enrollments

• Reassignments and updates to existing enrollments

• Managing ownership and managing control information

• Revalidations and maintenance of current enrollment records

Insurance payors and Medicare Administrative Contractors (MACs) use PECOS to validate your enrollment status. An outdated PECOS record can delay approvals, payments, and even risk termination of your billing privileges.

Who Should Have a PECOS Account?

Any individual or organization that intends to bill Medicare directly or through reassignment must have a PECOS account. This includes:

• Solo practitioners

• Group practices

• Facilities and suppliers

Even if you don’t plan to submit claims directly, you’ll need to enroll via PECOS if you’re reassigning benefits to a group or facility.

What’s Needed to Use PECOS?

To access PECOS, you’ll need:

• An active NPI (National Provider Identifier)—Type 1 for individuals, Type 2 for organizations

• A CMS Identity & Access (I&A) account, which connects your login credentials to your provider or practice

• An authorized surrogate user (if someone is managing PECOS on your behalf)

You’ll also need to have your business and personal documentation ready, such as license numbers, practice locations, and ownership details.

What to Watch Out For

PECOS is not always intuitive, and mistakes can lead to costly delays. Common issues include:

• Mismatches between your PECOS and NPPES records

• Missing supporting documents (such as IRS letters or state licenses)

• Incomplete revalidation submissions

• Forgetting to update ownership or practice location changes

It’s also important to check that your Medicare reassignment is properly linked if you’re part of a group practice.

Where to Start

You can access PECOS online at https://pecos.cms.hhs.gov. If you’ve never used the system before, start by creating an I&A account at https://nppes.cms.hhs.gov, then link your provider or practice information.

Need help navigating PECOS or submitting an enrollment? We’re here to help. Contact pie Health to streamline your Medicare enrollment process and avoid costly mistakes.