PECOS

PECOS is where a Medicare enrollment lives. CMS describes it as the online Medicare enrollment system, and its enrollment guide puts it second in the four steps to becoming a Medicare provider: get an NPI through NPPES, complete the application in PECOS, pay the application fee where one applies, then work with your Medicare Administrative Contractor (MAC) while it processes the file. Paper applications remain an option for those who cannot apply online, but the record still ends up in the same system.

The record matters because Medicare pays against it. The rendering NPI on an 837P has to match an active PECOS enrollment, the group has to hold a reassignment from each individual who bills under it, and the practice location and payment address have to be current. When any of those drift, claims stop or payments go to the wrong account. Revalidation requests, ownership changes and new locations all run through the same record.

The common mistake is treating PECOS as a one-time task. Billers file the enrollment, get the approval letter and never log in again. Then a provider leaves, a location closes or a revalidation notice goes to an old mailbox, and the first sign is a run of denials. Keep the PECOS login, the surrogate access and the record’s contact details with the billing team, and review every provider’s entry whenever anything about the practice changes.