Revenue-cycle answer from VOSKPO
What is payer enrollment for a medical practice?
Payer enrollment is the process that lets an eligible provider or organization participate, bill and get paid under a payer's rules. For Medicare, CMS directs providers through NPI, PECOS and the relevant Medicare Administrative Contractor (MAC), which issues the PTAN. Commercial plans and state Medicaid programs have their own requirements.
Source checked September 7, 2026 · General information, not legal, coding or payer-specific advice.
How VOSKPO approaches the work
- Confirm the provider, entity (Type 1 or Type 2 NPI), location and payer combination
- Collect the payer's current requirements
- Submit the application (PECOS or the CMS-855 forms for Medicare) and keep the complete record
- Track status, effective date and follow-up requests
Source
We checked this answer against CMS: Become a Medicare Provider or Supplier on September 7, 2026. Payer and legal requirements can change, so confirm the rule that applies to your practice.