Medicare enrollment is the hardest application in the credentialing stack. PECOS is unforgiving, the 855 forms ask questions that aren’t obvious until you’ve answered them wrong once, and the Medicare Administrative Contractor (MAC) review can sit for weeks before bouncing the file for a missing signature. PPS files Medicare enrollments for individual physicians, groups, and reassignments. We handle PECOS web submissions, paper backup filings when PECOS rejects, MAC follow-up, and the reassignment of benefits (855R) that ties an individual provider to a group’s billing number.
What’s included
- PECOS account setup or repair — including identity verification through I&A, which trips up about a third of new applicants.
- 855I, 855B, 855R, or 855O — whichever forms apply to your situation. We tell you which ones, you don’t have to guess.
- Document packet — license, DEA, board certifications, malpractice COI, EFT authorization, voided check.
- MAC submission and follow-up — every Medicare carrier has a different responsiveness profile. We know which ones answer the phone.
- Effective-date confirmation — written confirmation of approval and effective date, plus PTAN issuance.
- Revalidation calendar — Medicare revalidates every five years and the reminder window is short.
How it works
Week 1 — Intake. We pull your NPI, current PECOS state, license, and document set. If you’ve never had a Medicare number, we’re starting clean. If you have an existing enrollment with issues, we audit what’s there first.
Week 2 — Submission. PECOS web submission, or paper backup if PECOS errors out (still common in 2026, unfortunately).
Weeks 3-10 — MAC review. This is the calendar killer. MACs have a stated 45-60 day review window but routinely run longer. We follow up at week 4 and escalate at week 8.
Weeks 8-12 — Approval and PTAN issuance. Effective date is often retroactive to the application date, which matters for billing.
Realistic total: 60 to 120 days, with the variance entirely on the MAC’s review queue. Anyone telling you they can guarantee 45 days is selling you something.
Who this is for
- Physicians who’ve just gotten their first NPI and need to start billing Medicare.
- Groups onboarding a new provider who needs to be reassigned to the group’s billing number (855R).
- Practices whose Medicare enrollment lapsed because nobody tracked the 5-year revalidation.
- Telehealth practices needing multi-state Medicare enrollment.
Why Medicare is its own conversation
Commercial payer enrollment runs on private timelines and private rules. Medicare runs on federal regulations and a public help desk that often can’t help. The result: enrollments that are technically completable by anyone with the time, but practically completable only by people who file them every week. We file them every week. We know which MAC routes which document where, what triggers an automatic kickback, and which fields PECOS expects in which format. None of this is in the documentation.
If your billing company offers “Medicare enrollment included,” ask them how many they file a month. If the answer is under ten, that’s a team learning on your file.
Get started
Tell us your specialty, state, and whether you’re enrolling fresh or fixing an existing file. We’ll come back with a scope and a realistic timeline.
Start a Medicare enrollment scope — or learn about our full credentialing service for combined commercial + Medicare enrollment.