How to Get Credentialed with Medicare Fee-for-Service (CMS) in Arizona
Quick Overview
Timeline
45 - 120 days
CAQH
Not Required
Re-credentialing
Every 5 year(s)
Delegated
No
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.
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Arizona.
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).
Track & Follow Up
Credentialing typically takes 45-120 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
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Required Documents Checklist
Board Certification
ConditionalNot required for Medicare enrollment but verified during credentialing
DEA License
ConditionalRequired if applicable
Malpractice Insurance
Not required for Medicare FFS enrollment but required by most MACs
Medical License
NPI Certificate
Must be obtained first via NPPES
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.
RequiredCMS-855B — Group Practices / Organizations
For group practices, clinics, and organizations billing Medicare for services rendered by employed/contracted practitioners.
RequiredCMS-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.
RequiredCMS-855R — Reassignment of Benefits
Used when an individual practitioner reassigns their billing rights to a group practice.
Free Tools for Your Medicare Fee-for-Service (CMS) Enrollment
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Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- CMS-855
- The family of Medicare enrollment application forms used to enroll providers, suppliers, and organizations in the Medica...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- MAC
- A Medicare Administrative Contractor is a private company that CMS contracts with to process Medicare claims and handle...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- PECOS
- The Provider Enrollment, Chain, and Ownership System is the online portal used by healthcare providers to enroll in Medi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
Credentialing Checklist
Make sure you have everything ready before applying to Medicare Fee-for-Service (CMS).
View Physician Credentialing Checklist →Contact Information
PECOS Portal
National1-866-837-0241
NPPES (NPI)
National1-866-837-0241
Revalidation Due Date Checker
National1-866-837-0241
Medicare Provider Enrollment
National1-866-837-0241
Mon-Fri 8am-6pm ET
Medicare Provider Contact Center
National1-855-798-2627
Mon-Fri 8am-6pm local time
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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.