Deadline for Physician Enrollment in PECOS

Please be aware of a very important update regarding the Medicare program. The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for physician enrollment in the Medicare Provider Enrollment, Chain and Ownership System or PECOS (the electronic system used to enroll physicians and eligible professionals into the Medicare program).

The deadline to ensure your enrollment is current is Jan. 3, 2011. This means, effective Jan. 3, 2011, if you do not have a current enrollment record in PECOS, your Medicare claims will be rejected.

There has been much confusion in recent weeks regarding physician enrollment in PECOS because CMS had said the effective date for the regulation was July 6, 2010. After numerous complaints from physicians about problems with Medicare's enrollment system, CMS announced on June 30, 2010 that it would launch a review of PECOS and delay enforcement. That means CMS will not automatically reject physician claims for which the ordering or referring doctor is not properly enrolled in PECOS.

CMS advises that even physicians who have been enrolled in Medicare previously may not have an active file in PECOS. Generally, if you have not updated your record within the past six years, you may not be current. The process can be complicated and there have been system backlogs.  As a result, we advise you to enroll well before the deadline.

Following is a link from the Colorado Medical Society to an FAQ document you may find helpful. http://cms.org/livewire/021510/PecosFAQ.pdf