Did you know that if your provider is ordering items or services or referring to other providers or suppliers enrolled under Medicare

then your provider must enroll in the Provider Enrollment, Chain and Ownership System (PECOS)?

Even though CMS lifted the July 6, 2010 deadline (new deadline date not yet set) for providers to be enrolled in PECOS: {CMS (Centers

for Medicare and Medicaid Services) requires all providers enrolled in Medicare who are eligible to order items or services, or refer

Medicare beneficiaries to other Medicare providers or suppliers for services, must also be enrolled in PECOS. If you are not enrolled in

this system and submit a claim as the provider who ordered or referred a service, the claim will be rejected.}

Statement from; AMA President Cecil B. Wilson, MD “We are pleased that due to AMA efforts, CMS will not automatically reject claims

containing the names of referring or ordering physicians who are not yet enrolled in the Medicare PECOS system by July 6, 2010. We

continue to urge CMS not to reject any claims sooner than Jan. 3, [2011] the original date by which all referring and ordering

physicians were required to be enrolled.”

Although the new implementation date has not been determined, providers who order or refer Medicare beneficiaries for services or

supplies should continue to check:
• Their complete enrollment record is listed in PECOS.

• Claims include the individual National Provider Identifier (NPI) of the physician or eligible provider who made the referral or


Until the automatic rejections are operational, claims with enrollment discrepancies will not be rejected automatically. They will

continue to come back with informational edits noting that PECOS issues must be resolved.

Providers will eventually encounter claim rejections for services or supplies that are based on an order or referral if the referring

physician’s NPI is not on the claim; and/or if the referring physician is not properly enrolled in PECOS.

Visit this link to determine if your

information needs to be updated. If your name is on this list, you do not need to complete any further action. If your name is omitted

from this list, visit this link for more

information about submitting an updated application to CMS.

Deb Gonzalez