CMS Internet-only manual, Publication 100-04, Chapter 24, section 30 (PDF) requires providers and suppliers (collectively referred to as “providers”) to complete EDI enrollment. HETS is leveraging the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) process for you to request access to HETS, read and acknowledge our Rules of Behavior (PDF), and identify relationships with vendors and clearinghouses supporting your beneficiary eligibility EDI transactions. To access HETS, you must have an EDI enrollment to submit Medicare Fee-for-Service (FFS) claims transactions. Your MAC or CEDI will verify your claims EDI enrollment before approving HETS access.
The table below shows MACs who are currently accepting HETS EDI enrollment or their expected date. Until all MACs accept HETS EDI enrollments, we’re running parallel HETS trading partner management systems, where:
- Vendors and clearinghouses tell us the relationship they have with providers
- You attest to relationships with vendors and clearinghouses
Enroll for HETS Access with: | Electronic claims submitted to MAC jurisdictions: |
---|---|
CEDI | JA, JB, JC, or JD |
National Government Services | J6 (Home Health and Hospice (HH&H) or JK (HH&H) |
Noridian – March 2025 | JE or JF |
Novitas – June 2025 | JH or JL |
First Coast Service Options – June 2025 | JN |
Palmetto GBA – September 2025 | JJ or JM (HH&H) |
CGS – September 2025 | J15 (HH&H) |
WPS – December 2025 | J5 or J8 |
If you don’t enroll, you’ll lose access to HETS.
How Do I Enroll?
Your vendor or clearinghouse will share their unique ID that you’ll use to identify them when enrolling for HETS access. When your MAC is ready to accept HETS EDI enrollment, open the link in the table above. You’ll need:
- The name of the person authorized to sign on your behalf
- Email address
- Alternate email address (optional)
- Your Provider Transaction Access Number (PTAN)
- Your NPI
- Effective and termination date, if applicable, of your relationship with your vendor or clearinghouse
We’ll ask if you allow organizations outside the U.S. or its territories (offshore organizations) to use your NPI. You must tell us if your vendor or clearinghouse shares your data with offshore organizations.
While HIPAA rules don’t include requirements about business associates protecting electronic health information processed or stored outside the U.S., your risk may vary depending on geographic location.
If the third-party entity outsources work overseas, you may take on greater risks and vulnerabilities to the information. As a HIPAA-covered entity, consider these risks when conducting your risk analysis and management as required under the security rule at 45 CFR 164.308(a)(1)(ii)(A) and (a)(1)(ii)(B).
Keep Your Information Current
We’ll email you monthly reports detailing transactions associated with your NPI.
You’ll lose HETS access if our monthly transaction emails bounce back or we can’t contact you for your HETS EDI enrollment recertification.
What if I Don't Submit Electronic FFS Claims?
You won’t be able to have HETS access, but you can register to use your MAC’s secure internet portal to check Medicare eligibility (PDF).