PECOS: Provider Enrollment Chain and Ownership System
PECOS and Medicare Order and Refer Enrollment
What is PECOS? What does Order and Refer mean?
PECOS stands for the “Provider Enrollment Chain and Ownership System.” “Ordering/Referring provider” denotes an individual who orders refers, or certifies an item or service reported in a claim. PECOS enrollment is not specific to one hospital, and is transferable. See additional background information under Why do all residents/fellows need to be enrolled in Medicare to Order and Refer? (PECOS), below.
The UMN GME Office is requiring that all 2017/18 residents/fellows be enrolled in PECOS.
PECOS Enrollment Process
Conduct a search to determine if each resident/fellow in your program is already enrolled in PECOS (as orderer/referer, provider, or biller)
Assist residents/fellows in enrolling in Medicare to Order and Refer (PECOS) via one of two methods:
A paper application (CMS 8550) which programs are strongly encouraged to assist residents/fellows to complete, or an individual online enrollment, which residents/fellows complete individually on their own. Do not submit an Order and Refer application if the resident/fellow is already enrolled! (See step one, above)
- Paper Application:
- UMN Instructions on Enrolling and Updating PECOS Order and Refer (Paper and Online)
- UMN Guide - Paper Application CMS 8550
- Blank Paper Application Template - CMS 8550
- OR -
- Online Application
Report PECOS enrollment to GME/affiliated hospitals & sites
- *Reporting of PECOS status in RMS is required for all residents/fellows
Enrollment in PECOS (CMS 8550) via the Centers for Medicare and Medicaid Services (CMS) allows residents/fellows who do not already hold a biller/provider enrollment with CMS, to enroll and be eligible to order, certify, and/or prescribe Part D drugs, without having to list a separate authorized provider, and complete workarounds to ensure prescriptions go through the hospital and pharmacy without error. Enrollment of residents/fellows in PECOS will result in workflow improvements, have a positive impact on the patient experience when being discharged (CLER focus area), as well as reducing the work of the attending, thus allowing more time to focus on patient care. PECOS enrollment is managed by each individual program or department.
Nationally, CMS is requiring all residents/fellows (Part D prescribers) to be enrolled in PECOS (Order and Refer) by January 1, 2019. The UMN GME Office is requiring that all 2017/18 incoming residents/fellows be enrolled in PECOS to ensure compliance with the expectation that all continuing/advancing/changing program residents/fellows have already been enrolled in PECOS.
- UMN PECOS Information Overview and Enrollment Rollout Plan
- CMS Part D Prescriber Enrollment Information
Helpful links/contact information:
Contact CMS for PECOS technical assistance:
- CMS Part D Prescriber Enrollment Home
- “Who should I call?” CMS vs. MAC Provider Enrollment Assistance Guide
MAC (Medicare Appointed Contractor) contact:
Contact MAC for any application processing related questions.
National Government Services, Inc.
Address: National Government Services, Inc. Provider Enrollment
P.O. Box 6475
Indianapolis, IN 46206-6475