Step 1: Gather Required Documentation
Collect essential documents, including proof of identity (e.g., driver’s license), professional licenses, malpractice insurance, and tax identification number (TIN). Ensure all documents are current and legible.
- Resource: Medicare Provider Enrollment Checklist
Step 2: Complete the CMS-855 Form
Fill out the appropriate CMS-855 form based on your practice type:
- CMS-855I: For individual providers → Download CMS-855I Form
- CMS-855B: For group practices or clinics → Download CMS-855B Form
- CMS-855R: For reassignment of benefits → Download CMS-855R Form
Double-check for accuracy to avoid delays caused by errors or missing information.
Step 3: Submit the Application via PECOS or Paper
Submit electronically through the Provider Enrollment, Chain, and Ownership System (PECOS) or via paper submission. Electronic submissions are faster and allow real-time tracking.
- PECOS Portal: Access PECOS Here
- Paper Submission Address: Mail completed forms to the appropriate Medicare Administrative Contractor (MAC). Find your MAC here.
Step 4: Designate an Authorized Official
Identify an authorized official (AO) or delegated official (DO) who will act as the primary contact for Medicare communications.
Step 5: Monitor Application Status
Track your application status in PECOS or follow up with Medicare’s Provider Contact Center for paper submissions.
- PECOS Status Tracker: Track Your Application in PECOS
- Medicare Provider Contact Center: Call 1-800-MEDICARE (1-800-633-4227).
Step 6: Respond to Additional Requests (if applicable)
If Medicare requires further clarification or documentation, respond promptly to avoid delays. Use PECOS to upload additional documents securely.
Step 7: Receive and Review Approval Notification
Once approved, review the confirmation letter or email to ensure all details (e.g., PTAN, specialty, and location) are correct. Report discrepancies immediately.