Provider Enrollment

Providers Enrolled in Medicare in Approved or Opt-Out Status Website

Provider Enrollment Resources

  • PECOS - Click here to enroll, change your Medicare information, and add or delete group members or locations. Then 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 
    P.O. Box 100190
    Columbia, SC 29202

Provider Enrollment Tools

Opting Out of Medicare

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Latest Articles

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Jurisdiction M Provider Enrollment Virtual Open House 02/24/2021
CMS-855O Medicare Enrollment Application Module Open in New Window01/15/2021
Electronic Funds Transfer: Revised CMS-588 Required on February 28, 2021 01/08/2021
Changes to the Medicare Opt-Out Law for Physicians and Practitioners 12/31/2020
CMS-855 Applications Open in New Window12/31/2020
Credentialing Changes: Submit Updated Information Timely 12/31/2020
Cycle Two Provider Enrollment Revalidation Notifications 12/31/2020
Do You Need to Change Your Address on Your Provider File? 12/31/2020
Do You Need to Reactivate Your Medicare Number? 12/31/2020
Medicare Provider Enrollment Moratorium 12/31/2020
National CMS Opt Out Database Open in New Window12/31/2020
Online Medicare Enrollment: Internet-based PECOS 12/31/2020
Opt Out Information 12/31/2020
Participation Agreement Form and Instructions 12/31/2020
Physicians and Nonphysician Practitioners: New Medicare Enrollment Application 12/31/2020
Private Contract Sample for Providers that Opt Out of Medicare 12/31/2020
Provider Address Job Aid 12/31/2020
Provider Enrollment Application Average Processing Time 12/31/2020
Provider Enrollment Revalidation Cycle 2 Frequently Asked Questions (FAQs) 12/31/2020
Provider Enrollment Revalidation Informational Messaging 12/31/2020
Providers Opting Out of Medicare: Private Contracting 12/31/2020
Rebuttal Process: Provider Enrollment 12/31/2020
Sign Your Medicare Enrollment Application Electronically 12/31/2020
Medicare Opt-Out Affidavit 12/30/2020
Where can I locate a listing of the Medicare provider specialty codes? 12/01/2020
The Certified Provider Enrollment Process Loop 10/29/2020
Ambulance Supplier License Update Process Due to COVID-19 09/29/2020
Medicare Enrollment Application Fee Refunds through EFT 09/01/2020
Reassignment of Medicare Benefits: Revised CMS-855R Required May 1 05/01/2020
Provider Enrollment Hotline: Temporary Provisional Medicare Billing Privileges 04/09/2020
Revalidation Due Date Lookup Tool 02/08/2018
Provider Enrollment Email Communications 02/07/2018

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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