Provider Enrollment

Published 01/01/2020

If you are a provider interested in serving Medicare patients, CMS requires you to be enrolled with Medicare. The links below will provide you with the tools and information needed to quickly and efficiently complete your Medicare enrollment.

Provider Enrollment Resources

  • Enroll, change your Medicare information, and add or delete group members or locations using the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) at Print, sign and date the two-page Certification Statement and mail the Certification Statement and all supporting paper documentation to Palmetto GBA within seven days of electronic submission.
  • Provider Enrollment Revalidation
  • CMS file: providers eligible to order/refer and with current enrollment records
  • Access instructions (PDF, 89 KB) to view your PECOS record using Internet-based PECOS
  • CMS-855 forms access, print, sign and mail to Palmetto GBA:
    Palmetto GBA 
    Mail Code: AG-310
    P.O. Box 100306
    Columbia, SC 29202-3306

Provider Enrollment Tools

Opting Out of Medicare

Provider Enrollment Revalidation Informational MessagingChanges to the Medicare Opt-Out Law for Physicians and PractitionersProviders Opting Out of Medicare: Private ContractingPrivate Contract Sample for Providers that Opt Out of MedicareNational CMS Opt Out DatabaseOpt Out InformationProvider Address Job AidSign Your Medicare Enrollment Application ElectronicallyProvider Enrollment Application Average Processing TimeProvider Enrollment Application Average Processing TimeAmbulance Supplier License Update Process Due to COVID-19CMS-855 ApplicationsReassignment of Medicare Benefits: Revised CMS-855R Required May 1Revalidation Due Date Lookup ToolParticipation Agreement Form and InstructionsPhysicians and Nonphysician Practitioners: New Medicare Enrollment ApplicationCMS-855O Medicare Enrollment Application ModuleCycle Two Provider Enrollment Revalidation NotificationsOnline Medicare Enrollment: Internet-based PECOSRebuttal Process: Provider EnrollmentDo You Need to Change Your Address on Your Provider File?Credentialing Changes: Submit Updated Information TimelyProvider Enrollment Hotline: Temporary Provisional Medicare Billing PrivilegesInternet-Based Medicare Enrollment Now Available to Provider and Supplier Organizations in All States and in the District of ColumbiaInternet-Based Medicare Enrollment ApplicationMedicare Provider Enrollment MoratoriumMedicare Enrollment Application Fee Refunds through EFTProvider Enrollment Email CommunicationsProvider Enrollment Revalidation Cycle 2 Frequently Asked Questions (FAQ)Acronym/Terminology IndexMedicare Opt-Out AffidavitJurisdiction J Provider Enrollment Virtual Open House