Real-Time PECOS Search

What is PECOS?

PECOS is the e-portal that physicians or non-physician practitioner use to enroll in Medicare. All your physicians or non-physician practitioner need to be PECOS active, otherwise your claims will not be accepted.
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Some physicians don't have current records in PECOS because they haven't submitted any enrollment information updates to Medicare within the last 5 years.

Use these tool to check if the physicians or non-physician practitioners you work with are registered with CMS' PECOS program. CMS' rules state that claims sent to CMS will be rejected if an ordering or referring physician is not identified in the Medicare's PECOS enrollment system.

The PECOS enrollment data found here is directly connected to CMS PECOS in Real-Time, Learn More.

PECOS stands for Provider Enrollment and Chain/Ownership System.

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Let's talk about the PECOS lookup

The Provider Enrollment, Chain and Ownership System (PECOS) is a database of physicians or non-physician practitioner who are enrolled with Medicare. It allows registered users to securely and electronically submit and manage Medicare enrollment information.

For example, A physician wants to prescribe an item for his patients like a knee brace, the supplier must list the National Provider Identifier (NPI) number on the claim file. This NPI number will link that physicians provider file inside the PECOS system.

In order for a DMEPOS item to qualify for coverage by Medicare, a physician or a practitioner who is PECOS eligible to order the item must write the prescription. That physician must meet these requirements:

  1. Physicians or practitioners have registered in PECOS.
  2. Have a specialty that is eligible to order DMEPOS items for Medicare beneficiaries.

Pecos enrollment process

Your first step will be contracting either CMS directly at CMS.gov or MAC ( Medicare administrative contractor ) to get a enrollment application. Once you have applied you can follow the link above to check your Pecos application status or if you need to update your information like name, practice location and more.

Medicare Provider specialties eligible to order DMEPOS items include:

  • Doctor of Medicine or Osteopathy
  • Doctor of Dental Medicine or Dental Surgery
  • Doctor of Podiatric Medicine
  • Physician Assistant
  • Certified Clinical Nurse Specialist
  • Nurse Practitioner
  • Doctor of Optometry

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