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Pecos.cms.hhs.gov cms-855 Form: What You Should Know

Enrollment Status, and Enrollment Status Review for Reapplication. Once a provider application is approved and PECOS has matching information, the provider will be eligible to be enrolled as a Medicare Provider. Once a provider application is approved, PECOS will be updated with that provider's enrollment status. Providers/Suppliers will be sent a confirmation or update with the enrollment status. The provider application or update can also help you ensure that the provider is still enrolled in a Medicare Enrollment that is currently active. The following forms can be used for revalidations, changes in status, and voluntary termination: NOTE: No changes in PECOS or Enrollment Status, can apply after April 30, 2023. A Medicare Provider will have to re-apply by the date of their next PECOS. The following forms can be used for requesting a change in information regarding the practitioner's information through CMS: Additional Information In addition to the enrollment forms linked above, the U.S. Department of Health and Human Services has also provided the links and documentation below to help provide the guidance for your use of PECOS. PECOS Application to Enroll a Medicare Provider — CMS The online application can be found here: Medicare Provider Enrollment Tool Additional information for PECOS CMS has provided additional information regarding PECOS and Medicare Provider Enrollment.

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