Pecos Online Enrollment
As a result of the Patient Protection Affordable Care Act and a CMS issued Interim Final Rule that goes into effect July 6, 2010, physicians who have not enrolled in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) as participating, non-participating or opted out of physicians will not be permitted to order or refer patients for Medicare covered home health services.
PECOS is the enrollment system for Medicare providers and suppliers. If you enrolled in Medicare prior to 2003, and you have not submitted any updates to your Medicare enrollment information since then, you do not have a file in PECOS.
Effective July 6 2010, if you do not have an approved enrollment record in PECOS, Medicare will not pay for your patients’ home health services. As a result, home health agencies will most likely not accept your patients on to service. In addition, patients currently on service may be discharged, or seek care from a physician that does have a PECOS enrollment record.
If you do not have an approved enrollment record in PECOS, it is critical that you immediately begin the process. Medicare contractors have up to 45 days to process internet enrollment applications, and 60 days to process paper enrollment applications from the date of receipt of the signed and dated 2-page Certification Statement and the supporting documentation.
Using The Internet-based Pecos Enrollment System
What You Will Need
- A National Provider Identifier (NPI)
- a User ID and password in the National Plan and Provider Enumeration System (NPPES)
*You will need your NPPES User ID and password in order to access Internet-based PECOS.
Step 1. Read the documents that are available about Internet-based PECOS on the CMS Provider/Supplier Enrollment web page
Step 2. Enroll
Medicare Provider/Supplier Enrollment
Step 3. Once you have completed and submitted your enrollment application using Internet-based PECOS, be sure to:
- Print the Certification Statement
- **Sign and date it
- And Mail it, along with any required supporting documentation, to the carrier or A/B MAC whose name and mailing address will be displayed to you by the system
We suggest you mail it in a manner that provides you a delivery receipt.
*If you need help creating an NPPES User ID and password, or if you are not sure you ever created them or cannot remember what they are, you may contact the NPI Enumerator for assistance at 1-800-465-3203
**If you reassign some or all of your Medicare benefits to a group practice, there will be two Certification Statements to print, sign and date, and one of them will also need to be signed and dated by an Authorized Official of the group practice. The carrier or A/B MAC cannot process your web-submitted enrollment application without having the signed and dated Certification Statement(s) in hand.