Provider Enrollment

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 https://pecos.cms.hhs.gov. 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 PECOS
  • CMS-855 forms — Access, print, sign and mail to Palmetto GBA

Palmetto GBA 
P.O. Box 100190
Columbia, SC 29202

Provider Enrollment Tools

Opting Out of Medicare





Provider Enrollment Articles


Provider Enrollment Revalidation Informational MessagingMedicare Opt-Out AffidavitProviders Opting Out of Medicare: Private ContractingChanges to the Medicare Opt-Out Law for Physicians and PractitionersPrivate Contract Sample for Providers that Opt Out of MedicareNational CMS Opt Out DatabaseOpt Out InformationProvider Address Job AidProvider Enrollment Email CommunicationsSign Your Medicare Enrollment Application ElectronicallyAmbulance Supplier License Update Process Due to COVID-19Provider Enrollment Application Average Processing TimeProvider Enrollment Application Average Processing TimeAcronym/Terminology IndexCMS-855 ApplicationsReassignment of Medicare Benefits: Revised CMS-855R Required May 1Physicians and Nonphysician Practitioners: New Medicare Enrollment ApplicationCMS-885O Medicare Enrollment Application ModuleRevalidation Due Date Lookup ToolParticipation Agreement Form and InstructionsCredentialing Changes: Submit Updated Information TimelyDo You Need to Change Your Address on Your Provider File?Online Medicare Enrollment: Internet-based PECOSRebuttal Process: Provider EnrollmentCycle Two Provider Enrollment Revalidation NotificationsProvider Enrollment Hotline: Temporary Provisional Medicare Billing PrivilegesInternet-Based Medicare Enrollment ApplicationInternet-Based Medicare Enrollment Now Available to Provider and Supplier Organizations in All States and in the District of ColumbiaElectronic Funds Transfer: Revised CMS-588 Required on February 28, 2021Medicare Enrollment Application Fee Refunds through EFTMedicare Provider Enrollment MoratoriumProvider Enrollment Revalidation Cycle 2 Frequently Asked Questions (FAQ)Jurisdiction M Provider Enrollment Virtual Open House