Manage Your Enrollment

Manage Your Enrollment

Manage Your Enrollment

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Get Started With PECOS

PECOS is the online Medicare enrollment management system which allows you to:

  • Enroll as a Medicare provider or supplier
  • Revalidate (renew) your enrollment
  • Withdraw from the Medicare program
  • Review and update your information
  • Report changes to your enrollment record
  • Electronically sign and submit your information

PECOS applications are processed more quickly than paper applications. Because PECOS is paperless, you’re no longer required to submit anything by mail. Additionally, PECOS is tailored to ensure that you only supply information that’s relevant to your application. The PECOS system has video and print tutorials to get you started.

Go to PECOS.

Need more help?

Did you know your enrollment contractor can answer questions you may have about your application? Medicare Administrative Contractors (MACs) process enrollment applications for providers, group practices, and non-DMEPOS suppliers. The National Provider Enrollment DMEPOS East and West contractors process enrollment applications for DMEPOS suppliers.

Find your enrollment contractor (PDF).

Withdraw From Medicare

If you retire, surrender your license, or no longer want to participate in the Medicare program, you must officially withdraw within 90 days. DMEPOS suppliers must withdraw within 30 days.

Withdraw Online Using PECOS

PECOS is the online Medicare enrollment management system which allows you to review information currently on file and withdraw electronically. The PECOS system has print and video tutorials to walk you through different scenarios of withdrawing from Medicare:

  • End a reassignment to an organization but maintain another reassignment to the same organization
  • End reassignment to one organization but maintain reassignment to a different organization
  • End employment with an organization
  • Completely withdraw from the Medicare program
  • End a practice location
  • Move to another state
  • Switch from reassigning benefits to becoming the sole owner of your corporation


Failing to withdraw could result in fraudulent billing or having your Medicare billing privileges revoked.

Withdraw online using PECOS.

Withdraw Using a Paper Application

If you’re unable to withdraw online using PECOS, you can use a paper application.

Opt Out of Medicare

Physicians and practitioners who see Medicare patients but don’t want to enroll in the Medicare program must opt-out of Medicare. This means you and your Medicare patients can’t bill Medicare for services and your Medicare patients pay out of pocket. As an opt-out, you can elect to order and certify Medicare items and services for your Medicare patients. 

If you don’t see Medicare patients, you don’t have to enroll in or opt-out of Medicare.

We’ll include your decision to opt-out on the CMS Opt-Out Dataset.

To opt-out, you must:

  • Be an eligible type or specialty.
  • Submit an opt-out affidavit to Medicare.
  • Enter into a private contract with each of your Medicare patients. This contract will reflect the agreement between you and your Medicare patients that they will pay for services out of pocket, and that nobody will submit the bill to Medicare for payment. However, you can’t:
    • Sign such contracts with Medicare patients who need emergency or urgent care services
    • Choose to opt-out of Medicare for some Medicare patients and services but not for others

Contact your Medicare Administrative Contractor (MAC) (PDF) to get the standard affidavit form and the information you must include in your opt-out affidavit and private contract. The opt-out affidavit must:

  • Be in writing and signed by you
  • Include the necessary statements to which you agree
  • Identify you so that the MAC can make sure Medicare doesn’t pay you during the opt-out period
  • Be filed with all MACs who have jurisdiction over the claims

Section 10.6.12(B)(1) of the Medicare Program Integrity Manual, Chapter 10 and Section 40.9 of the Medicare Benefit Policy Manual, Chapter 15, has more information on the opt-out affidavit requirements.

Note: You can’t enroll in Medicare and opt-out of Medicare. The only exception is to enroll to get paid for emergency or urgent care services. You may opt-out of Medicare at any time. If you’re opting out in multiple MAC jurisdictions, you must file a separate opt-out affidavit with each MAC. Your opt-out effective date is based on your participation status.

Opt-Out Period

If you never enrolled in Medicare or were previously enrolled as a non-participating provider, then your opt-out period starts the date you sign your opt-out affidavit. If you were previously enrolled as a participating provider, your opt-out period starts the 1st day of the next calendar quarter, that’s if the affidavit was submitted at least 30 days before the start of the quarter. 

Canceling an Opt-Out Status

To cancel your opt-out status, mail a cancellation request to your MAC at least 30 days before your opt-out period is set to expire. If you don’t submit your cancellation request before the 30-day period, your opt-out status will automatically renew for another 2 year cycle.

Early Termination

You can terminate your opt-out status within the first 90 days of submitting an initial opt-out affidavit. (Once an opt-out is automatically renewed, you can’t terminate early.)

Renewing an Opt-Out Status

If you’re currently opted out, your opt-out status will automatically renew every 2 years.

Providers Eligible to Opt Out

  • Doctors of medicine
  • Doctors of osteopathy
  • Doctors of dental surgery or dental medicine
  • Doctors of podiatric medicine
  • Doctors of optometry
  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Certified nurse midwives
  • Clinical psychologists
  • Clinical social workers
  • Registered dieticians and nutrition professionals
  • Marriage and family therapists
  • Mental health counselors

Providers NOT Eligible to Opt Out

  • Anesthesiology assistants
  • Chiropractors
  • Occupational therapists
  • Physical therapists
  • Qualified audiologists
  • Qualified speech language pathologists


Medicare Advantage plans:

  • May not pay (directly or indirectly) for basic services provided to a Medicare enrollee by a physician or practitioner who filed a valid opt-out affidavit with Medicare.
  • Must pay for urgent care or emergency services provided by a physician or practitioner who hasn’t signed a private contract with the patient they’re treating.
  • May make payment to an opted out physician or practitioner for services that aren’t basic benefits but are provided to a patient as a supplemental benefit. 42 CFR 422.102 has more information.


Page Last Modified:
04/22/2024 02:57 PM