What is PECOS, and what role does it play in Medicare enrollment?

PECOS is CMS’s online Medicare enrollment management system. Providers and suppliers can use it to submit enrollment applications, update enrollment information, upload supporting documents, revalidate enrollment, and manage other Medicare enrollment actions.

PECOS stands for the Provider Enrollment, Chain, and Ownership System. It is CMS’s online system for managing Medicare provider and supplier enrollment.

Depending on the provider or supplier type and transaction, PECOS can be used to submit an initial Medicare enrollment application, review information currently on file, upload supporting documents, report changes, revalidate enrollment, manage certain reassignment or organization relationships, and electronically sign and submit applicable enrollment information.

Applications are processed by the appropriate Medicare enrollment contractor, such as a Medicare Administrative Contractor for many providers and organizations.

PECOS is not a general commercial payer credentialing platform. It is specific to Medicare enrollment management.

• PECOS is CMS’s Medicare enrollment management system.
• It supports initial enrollment, updates, and revalidation.
• Supporting documents can be submitted through PECOS.
• Medicare contractors process enrollment applications.
• PECOS is different from CAQH and commercial payer credentialing systems.

A medical group hires a new physician. The credentialing specialist confirms the physician’s NPI, completes the required Medicare enrollment transaction in PECOS, uploads supporting information, and monitors the Medicare contractor’s requests until the enrollment and group relationship are approved.

• Confusing PECOS with CAQH.
• Assuming submission means approval.
• Ignoring contractor requests for additional information.
• Failing to update PECOS after required enrollment changes.

Describe PECOS as the Medicare enrollment management system and mention several actions it supports rather than defining it only by the acronym.