Medicare Enrollment Guide
To participate in the ACCESS Model, organizations must be enrolled in Medicare Part B as a provider or supplier under the Medicare fee-for-service program. This guide walks you through the enrollment process step by step.
Start Early
Because ACCESS applications cannot be approved until Medicare enrollment is complete, organizations that are not yet enrolled are encouraged to begin the Medicare enrollment process as early as possible to avoid delays in model participation. The enrollment process can take several months.
Who Should Use This Guide
This guide is for organizations that want to participate in the ACCESS Model and need to enroll in Medicare Part B. Use this guide if:
- You're a health care provider who wants to bill Medicare for services
- You're a technology-enabled care organization seeking to participate in ACCESS
- You need to verify or update your existing Medicare enrollment
- You're a new organization preparing for ACCESS participation
Exclusions
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers and laboratory suppliers are not eligible to participate in the ACCESS Model, even if enrolled in Medicare.
Enrollment Process Overview
Step-by-Step Enrollment
Get a National Provider Identifier (NPI)
If you already have an NPI, skip to Step 2. NPIs are issued through the National Plan & Provider Enumeration System (NPPES).
The NPI is a unique 10-digit identification number required for all health care providers. You'll need this before you can complete Medicare enrollment.
Apply for an NPI
National Plan & Provider Enumeration System (NPPES) application portal
Search NPI Registry
Verify existing NPIs or look up provider information
Complete Medicare Enrollment Application
Enroll using PECOS (Provider Enrollment, Chain, and Ownership System), the online Medicare enrollment system. PECOS provides video and print tutorials and will walk you through your enrollment to ensure your information is accurate.
Access PECOS
Provider Enrollment, Chain, and Ownership System - Online Medicare enrollment
What you'll need for your application:
- National Provider Identifier (NPI)
- Tax Identification Number (TIN)
- Practice location information
- Ownership and managing control information
- Authorized official information
- Supporting documentation as required
Work With Your Medicare Administrative Contractor (MAC)
Your MAC is specific to the region where you practice and may have additional requests for information while they process your application. You can also check in with your MAC regarding your enrollment status.
MACs are responsible for:
- Reviewing your enrollment application
- Requesting additional information if needed
- Notifying you once enrollment is approved
- Answering questions about the enrollment process
ACCESS Model Requirements
Beyond standard Medicare enrollment, ACCESS participants must meet additional requirements:
Participation Requirements
What type of Medicare enrollment is required?▼
Organizations must be enrolled in Medicare Part B as a provider or supplier under the Medicare fee-for-service program. This means you must accept Medicare assignment and the Medicare-allowed amount as payment in full for covered services.
What about individual practitioners?▼
All physicians and non-physician practitioners furnishing or supervising care must be individually Medicare-enrolled and have reassigned their billing rights to the ACCESS participant organization.
Is a Clinical Director required?▼
Yes, each ACCESS participant organization must designate a physician Clinical Director who is Medicare-enrolled and responsible for clinical oversight and compliance.
Can I apply to ACCESS while enrollment is pending?▼
You may submit an ACCESS application while your Medicare enrollment is in process, but your ACCESS application cannot be approved until Medicare enrollment is complete.
Keeping Your Information Current
It's critical to keep your enrollment information up to date. To avoid having your Medicare billing privileges revoked, report changes promptly:
Within 30 Days
- A change in ownership
- An adverse legal action
- A change in practice location
Within 90 Days
- All other changes (contact information, authorized officials, etc.)
Updating Information
If you applied online, you can keep your information up to date in PECOS. If you applied using a paper application, you'll need to resubmit your form to update information.
Enrollment Timeline
Understanding the typical timeline helps you plan for ACCESS participation:
Week 1-2
NPI Application
Apply through NPPES if you don't already have an NPI
Week 2-4
PECOS Application
Complete and submit your Medicare enrollment application online
Week 4-12
MAC Review
Your Medicare Administrative Contractor reviews your application
Week 12-16
Additional Information (if needed)
Respond to any MAC requests for additional documentation
Week 16-24
Approval
Receive notification of enrollment approval
Helpful Resources
CMS Enrollment Resources
Medicare Provider Enrollment Portal
CMS official guide to enrolling as a Medicare provider or supplier
PECOS Help & Resources
Tutorials, FAQs, and support for the PECOS enrollment system
Find Your MAC
MAC Contact Information
Find your Medicare Administrative Contractor by state or region
Common Enrollment Questions
How long does Medicare enrollment take?▼
The timeline varies, but typically ranges from 3-6 months. Starting early is essential if you plan to participate in ACCESS from the first performance period beginning July 5, 2026.
Is there a fee to enroll in Medicare?▼
No, there is no fee to enroll in Medicare as a provider or supplier.
Can I check my enrollment status?▼
Yes, you can check your enrollment status through PECOS or by contacting your MAC directly.
What if my application is denied?▼
If your application is denied, you'll receive a denial letter explaining the reason. You may be able to correct issues and reapply, or you may have appeal rights depending on the reason for denial.
Do I need to re-enroll periodically?▼
Medicare providers and suppliers must revalidate their enrollment periodically (typically every 3-5 years). CMS will notify you when revalidation is due.
Need Help?
Your MAC can help you navigate the enrollment process and answer questions about your application. For ACCESS-specific enrollment questions:
Email: ACCESSModelTeam@cms.hhs.gov
Next Steps
Once your Medicare enrollment is complete, you're ready to apply for the ACCESS Model:
Check ACCESS Eligibility
Review all requirements for ACCESS Model participation
Download Application Materials
Access the Request for Applications and other official documents
Review Technical Requirements
Understand the technology infrastructure needed for ACCESS