Don’t miss this important December 31 deadline

All Medicare providers must enroll in the Medicare PECOS system by December 31, 2010

by Government Relations Staff

October 27, 2010 — By December 31, 2010, all Medicare providers must enroll or verify enrollment information via the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). Failure to register with PECOS will result in the denial of Medicare claims as of January 1, 2011.

PECOS is an internet-based system for mandatory Medicare provider enrollment that verifies providers have a valid National Provider Identifier (NPI). Providers who enrolled prior to 2003 or who have not updated their enrollment information since 2003 should verify their enrollment status to ensure that they are included.

In order to enroll, providers must have a web user account with the National Plan and Provider Enumeration System (NPPES) administered by the Centers for Medicare and Medicaid Services (CMS), and must have an established National Provider Identifier (NPI). However, simply having an NPI does not guarantee that providers are enrolled.

After January 1, 2011, if a psychologist or a referring physician who is not enrolled in PECOS is listed on a Medicare claim, the claim will be denied.

The PECOS system and registration instructions can be accessed online through the Medicare Enrollment site.