Create the I&A account
Everything starts at the CMS Identity & Access Management System. Each person uses their own login (sharing credentials violates CMS rules). The practice’s authorized official creates the account, then can delegate staff.File the right 855s
A typical new practice files one 855B, one 855I per provider, and an 855R
linking each provider to the group. File them together in PECOS.
Set up EFT with the CMS-588
The EFT section of the PECOS application is the CMS-588. You need the exact entity name, the bank routing and account numbers, and a voided check or bank letter upload. The deposit account must belong to the enrolled entity. Changing banks later means a new CMS-588 through PECOS or your MAC (see the Medicare pages in the payer directory).Know your MAC
CMS outsources processing to regional Medicare Administrative Contractors (Novitas, Palmetto, Noridian, and others, by state). The MAC is who you call about a stuck application and where paper CMS-588s go. Find yours on cms.gov, then use the matching portal page: Novitas, Palmetto.After approval
Note your PTAN and your effective date. Medicare allows limited retroactive billing (generally 30 days before the application receipt date), so date of first Medicare patient matters. Then calendar revalidation: Medicare requires it roughly every 5 years and deactivates billing if you miss it.Not planning to bill Medicare at all? You still must choose a position:
non-participating, or formally opted out with private contracts. See the
cash-pay model.