Medicare Fee-for-Service (CMS)
Credentialing and enrollment guides for Medicare Fee-for-Service (CMS) across 51 states.
Quick Overview
Timeline
45 - 120 days
CAQH
Not Required
Re-credentialing
Every 5 year(s)
States Available
51
How Medicare Fee-for-Service (CMS) Credentialing Actually Works
Verified July 2026Apply Through
Timeline
PECOS web runs about 45 to 60 days typical (about 7 days best case on a clean file); paper or applications with information requests run 90 to 180 days
Recredentialing
Revalidation every 5 years (3 for DMEPOS), with NO grace period: a missed revalidation means payment hold, deactivation, and a non retroactive unbillable gap
Enrollment files through PECOS (the 855 series), which auto routes to the Medicare Administrative Contractor for your practice state. Access is gated by an I&A account first: for organizations, an Authorized Official; for firms working on your behalf, an accepted surrogate connection. That connection approval is the true first gate.
Behavioral health routing: Marriage and family therapists and mental health counselors have been enrollable since January 2024 via the 855I; the 3,000 hour documentation is the common stall.
The stall to avoid: Your effective date is the later of filing date or first service date, with retroactive billing capped at 30 days. And not answering a development request within 30 days is a rejection: you start over.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
About Medicare Fee-for-Service (CMS)
Federal health insurance program. Enrollment via PECOS. CMS-855 forms required. Processed by Medicare Administrative Contractors (MACs).
How to Get Credentialed
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and board certifications.
Prepare Your Application
Complete Medicare Fee-for-Service (CMS)'s provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to Medicare Fee-for-Service (CMS). Select your state below for state-specific submission details.
Track & Follow Up
Credentialing typically takes 45-120 days. Monitor your application and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Medicare Fee-for-Service (CMS)?
Our specialists handle the entire Medicare Fee-for-Service (CMS) enrollment process: applications, follow-ups, and approvals across all 50 states.
Required Documents
Board Certification
Not required for Medicare enrollment but verified during credentialing
DEA License
Required if applicable
Malpractice Insurance
Medical License
NPI Certificate
Enrollment Forms
CMS-855I — Individual Practitioners
For physicians and non-physician practitioners enrolling as individuals who will bill Medicare directly or reassign benefits to a group.
CMS-855B — Group Practices / Organizations
For group practices, clinics, and organizations billing Medicare for services rendered by employed/contracted practitioners.
CMS-855O — Ordering/Certifying Only
For physicians who ONLY order or certify items/services for Medicare beneficiaries but do NOT bill Medicare directly.
CMS-855S — DMEPOS Suppliers
For suppliers of durable medical equipment, prosthetics, orthotics, and supplies.
CMS-855R — Reassignment of Benefits
Used when an individual practitioner reassigns their billing rights to a group practice.
Contact Information
PECOS Portal
1-866-837-0241
NPPES (NPI)
1-866-837-0241
Revalidation Due Date Checker
1-866-837-0241
Medicare Provider Enrollment
1-866-837-0241
Mon-Fri 8am-6pm ET
Medicare Provider Contact Center
1-855-798-2627
Mon-Fri 8am-6pm local time
Need Help?
Let PayerReady handle your Medicare Fee-for-Service (CMS) credentialing and enrollment.
Get Started NowAvailable States
+ 36 more states below
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.
Select Your State
Choose your state for Medicare Fee-for-Service (CMS)-specific credentialing details including timelines, contacts, and local requirements.
Medicare Fee-for-Service (CMS) credentialing requirements by state
Medicare Fee-for-Service (CMS) enrollment is not identical everywhere. The table below lists what actually differs across the 51 states Medicare Fee-for-Service (CMS) operates in — network status, local plan names, portals and the state-specific conditions our credentialing team has recorded.
| State | Local plan | Network | Portal / phone | State-specific notes |
|---|---|---|---|---|
| Alaska | — | Open | — | — |
| Alabama | — | Open | — | — |
| Arkansas | — | Open | — | — |
| Arizona | — | Open | — | — |
| California | — | Open | — | — |
| Colorado | Medicare (Novitas Solutions, Jurisdiction JH) | Open |
Provider portal
1-855-252-8782
|
Medicare fee-for-service enrollment runs through PECOS (the Provider Enrollment, Chain and Ownership System) at pecos.cms.hhs.gov, using the CMS-855I (physicians/non-physician practitioners), CMS-855B (groups), or CMS-855A (institutions); reassignment is now reported on the 855I (the standalone 855R was merged into it). Physicians and non-physician practitioners do NOT pay the enrollment application fee (the CY2026 fee of $750 applies to institutional providers). CMS processes most clean PECOS applications without a site visit within 15 calendar days (longer with development or fingerprinting). Get an NPI first. Billing privileges are generally effective the date of filing the approved application, with up to 30 days of retrospective billing. Revalidation occurs every 5 years. In Colorado, Medicare Part A/B claims and enrollment are handled by Novitas Solutions (Jurisdiction JH). |
| Connecticut | — | Open | — | — |
| District Of Columbia | — | Open | — | — |
| Delaware | — | Open | — | — |
| Florida | — | Open | — | — |
| Georgia | — | Open | — | — |
| Hawaii | — | Open | — | — |
| Iowa | — | Open | — | — |
| Idaho | — | Open | — | — |
| Illinois | — | Open | — | — |
| Indiana | — | Open | — | — |
| Kansas | — | Open | — | — |
| Kentucky | — | Open | — | — |
| Louisiana | — | Open | — | — |
| Massachusetts | — | Open | — | — |
| Maryland | — | Open | — | — |
| Maine | — | Open | — | — |
| Michigan | Medicare (WPS GHA, Jurisdiction J8) | Open |
Provider portal
1-866-234-7331
|
Medicare fee-for-service enrollment runs through PECOS (the Provider Enrollment, Chain and Ownership System) at pecos.cms.hhs.gov, using the CMS-855I (physicians/non-physician practitioners), CMS-855B (groups), or CMS-855A (institutions); reassignment is now reported on the 855I (the standalone 855R was merged into it). Physicians and non-physician practitioners do NOT pay the enrollment application fee (the CY2026 fee of $750 applies to institutional providers). CMS processes most clean PECOS applications without a site visit within 15 calendar days (longer with development or fingerprinting). Get an NPI first. Billing privileges are generally effective the date of filing the approved application, with up to 30 days of retrospective billing. Revalidation occurs every 5 years. In Michigan, Medicare Part A/B claims and enrollment are handled by WPS Government Health Administrators (Jurisdiction J8). |
| Minnesota | — | Open | — | — |
| Missouri | — | Open | — | — |
| Mississippi | — | Open | — | — |
| Montana | — | Open | — | — |
| North Carolina | Medicare (Palmetto GBA, Jurisdiction JM) | Open |
Provider portal
1-855-696-0705
|
Medicare fee-for-service enrollment runs through PECOS (the Provider Enrollment, Chain and Ownership System) at pecos.cms.hhs.gov, using the CMS-855I (physicians/non-physician practitioners), CMS-855B (groups), or CMS-855A (institutions); reassignment is now reported on the 855I (the standalone 855R was merged into it). Physicians and non-physician practitioners do NOT pay the enrollment application fee (the CY2026 fee of $750 applies to institutional providers). CMS processes most clean PECOS applications without a site visit within 15 calendar days (longer with development or fingerprinting). Get an NPI first. Billing privileges are generally effective the date of filing the approved application, with up to 30 days of retrospective billing. Revalidation occurs every 5 years. In North Carolina, Medicare Part A/B claims and enrollment are handled by Palmetto GBA (Jurisdiction JM). |
| North Dakota | — | Open | — | — |
| Nebraska | — | Open | — | — |
| New Hampshire | — | Open | — | — |
| New Jersey | — | Open | — | — |
| New Mexico | — | Open | — | — |
| Nevada | — | Open | — | — |
| New York | — | Open | — | — |
| Ohio | — | Open | — | — |
| Oklahoma | — | Open | — | — |
| Oregon | — | Open | — | — |
| Pennsylvania | — | Open | — | — |
| Rhode Island | — | Open | — | — |
| South Carolina | — | Open | — | — |
| South Dakota | — | Open | — | — |
| Tennessee | — | Open | — | — |
| Texas | Medicare (Novitas Solutions, Jurisdiction JH) | Open |
Provider portal
1-855-252-8782
|
Medicare fee-for-service enrollment runs through PECOS (the Provider Enrollment, Chain and Ownership System) at pecos.cms.hhs.gov, using the CMS-855I (physicians/non-physician practitioners), CMS-855B (groups), or CMS-855A (institutions); reassignment is now reported on the 855I (the standalone 855R was merged into it). Physicians and non-physician practitioners do NOT pay the enrollment application fee (the CY2026 fee of $750 applies to institutional providers). CMS processes most clean PECOS applications without a site visit within 15 calendar days (longer with development or fingerprinting). Get an NPI first. Billing privileges are generally effective the date of filing the approved application, with up to 30 days of retrospective billing. Revalidation occurs every 5 years. In Texas, Medicare Part A/B claims and enrollment are handled by Novitas Solutions (Jurisdiction JH). |
| Utah | — | Open | — | — |
| Virginia | — | Open | — | — |
| Vermont | — | Open | — | — |
| Washington | — | Open | — | — |
| Wisconsin | — | Open | — | — |
| West Virginia | — | Open | — | — |
| Wyoming | — | Open | — | — |
Compiled and maintained by the PayerReady credentialing team from payer portals and direct payer contact. Last verified June 10, 2026. Network status changes without notice — confirm before you file.
Common questions about Medicare Fee-for-Service (CMS) credentialing
How long does Medicare Fee-for-Service (CMS) credentialing take?
Medicare Fee-for-Service (CMS) credentialing typically takes 45–120 days from a complete submission to an approved effective date. Incomplete applications are the main cause of delay: a missing document or an unattested CAQH profile restarts the clock rather than pausing it.
Does Medicare Fee-for-Service (CMS) require CAQH?
No. Medicare Fee-for-Service (CMS) does not enroll through CAQH ProView, so credentialing data is submitted directly on Medicare Fee-for-Service (CMS)'s own application instead. You still need the same underlying documents — license, DEA where applicable, malpractice coverage and work history.
Which states does Medicare Fee-for-Service (CMS) operate in?
Medicare Fee-for-Service (CMS) has credentialing operations in 51 states. 51 of those 51 currently show an open panel. Requirements are not uniform: local plan names, provider portals and state-specific conditions differ, which is what the state-by-state table above records.