Medicare Provider Enrollment Wizard
Enroll or reassign benefits, one small step at a time.
Answer a few simple questions, then get guidance for your next task. Enroll a new clinician or go straight to adding, changing, or ending a Medicare reassignment.
We never ask for or transmit an SSN, CMS password, PTAN, bank information, or credentialing documents. You complete the real work on official CMS, NPPES, PECOS, Novitas, and Texas licensing websites.
Let’s find your path · One question at a time
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Special situation
I'm hiring a new graduate
Special situation
I'm hiring a new graduate
License before enrollment?
For the standard Texas PT/OT path, wait until the current Texas license can be verified and enter it accurately in PECOS. A pending or temporary license should not be treated as automatic proof that Medicare will enroll or pay the clinician.
NPI before full licensure?
An NPI can be obtained independently, but it does not validate licensure, qualifications, or Medicare enrollment. Keep NPPES information accurate as status changes.
Texas temporary licenses
Texas temporary PT and OT licenses have category-specific eligibility and onsite/on-premises supervision restrictions. Do not assume supervision makes an unenrolled clinician's services Medicare-payable.
What to verify
Confirm the current Texas license online, Medicare therapist qualifications, the proposed setting, supervision requirements, and the specific case with Novitas before relying on a temporary-license path.
Searchable answers
Medicare enrollment FAQ
31 questions
NPIDoes every clinician need their own NPI?
Yes. Each clinician needs a Type 1 NPI; the practice’s Type 2 NPI does not replace it.
NPIWhat's the difference between Type 1 and Type 2 NPI?
Type 1 identifies an individual health care provider. Type 2 identifies an organization such as a group practice.
NPICan the practice apply for the clinician's NPI?
Yes, through an authorized NPPES employee or surrogate workflow. The helper uses their own account.
NPIDoes an NPI mean you're enrolled in Medicare?
No. An NPI is an identifier. Medicare enrollment and reassignment are separate CMS approval processes.
CMS / PECOSWhat is PECOS?
The CMS website for submitting and managing Medicare enrollment.
CMS / PECOSWhat is CMS I&A?
CMS Identity & Access verifies identity and controls who may use systems such as NPPES and PECOS.
CMS / PECOSDoes the clinician have to complete PECOS themselves?
An authorized preparer can help. The clinician remains responsible for accuracy and required signatures.
CMS / PECOSCan the clinic complete PECOS for them?
Yes, with approved CMS access. The clinician still completes required signatures using their own account.
CMS / PECOSCan I use the clinician's PECOS password?
No. Use your own CMS account and approved access to the clinician’s record.
CMS / PECOSWhat is surrogate access?
Permission for the practice to manage the clinician’s selected CMS records. It grants access, not billing reassignment. Staff preparers may also need individual permissions.
CMS / PECOSWhat is a Staff End User?
A person approved to prepare selected CMS work. This role cannot manage connections or sign for someone else.
Medicare enrollmentWhat is CMS-855I?
The individual practitioner Medicare enrollment application, including reassignment. PECOS provides the online workflow.
Medicare enrollmentDo I still use CMS-855R?
No. CMS discontinued CMS-855R and incorporated reassignment actions into CMS-855I and PECOS.
Medicare enrollmentWhat is a PTAN?
A PTAN is a Medicare enrollment identifier associated with an approved Medicare enrollment. Handle it as sensitive credentialing information.
Medicare enrollmentIs PTAN the same as NPI?
No. The NPI is a permanent national identifier; the PTAN is tied to Medicare enrollment.
Medicare enrollmentHow do I check Medicare enrollment status?
Use PECOS and the official status or contact methods supplied by CMS and the applicable MAC. For the supported Texas Part B path, use Novitas provider-enrollment resources.
ReassignmentWhat does reassignment mean?
It lets an eligible enrolled practice bill and receive Medicare payment for an individually enrolled clinician’s covered services.
ReassignmentWho receives the Medicare payment?
With an approved reassignment, the eligible billing organization generally receives payment under CMS rules.
ReassignmentIs the clinician still independently enrolled?
Yes. Reassignment does not replace the clinician’s individual enrollment.
ReassignmentCan an employee reassign benefits?
Yes, when the relationship meets CMS requirements. Employment alone does not complete or approve reassignment.
ReassignmentCan an independent contractor reassign benefits?
Some arrangements qualify. Confirm the arrangement with PECOS or the Medicare contractor; contractor status alone is not enough.
ReassignmentWhat happens if the clinician leaves the practice?
Promptly update or end the reassignment and affected locations in PECOS. The clinician keeps their NPI.
TimingCan the clinician treat patients while Medicare enrollment is pending?
Verify state licensure and supervision separately. Do not assume Medicare payment until enrollment, reassignment, and approved dates are confirmed.
TimingCan Medicare claims be billed retroactively?
Sometimes, if all CMS conditions are met. Confirm the approved enrollment and reassignment dates with the Medicare contractor before billing.
TimingWhat determines the effective date?
For these suppliers, the billing-privilege date is generally the later of an enrollment filing date that is subsequently approved or the date services first began at the enrolled location, subject to current CMS rules. Use the dates Medicare actually approves.
TimingHow long does enrollment take?
Processing time varies. Track the application and answer contractor requests promptly; unofficial estimates are not guaranteed.
Practice questionsDoes my clinic need its own Medicare enrollment?
A practice receiving Medicare payment generally needs its own organization enrollment. Set this up separately from each clinician’s enrollment and reassignment.
Practice questionsWhat if my practice is already enrolled?
Each clinician still needs individual enrollment and the correct reassignment and practice location.
Practice questionsCan PT and OT bill through the same organization?
Yes, if the organization is eligible and each clinician, specialty, location, reassignment, and claim is set up correctly.
Practice questionsCan a mobile outpatient practice enroll an OT?
Potentially. Confirm the service-location setup and therapy requirements with PECOS and Novitas before billing.
Practice questionsCan the clinician work at more than one location?
Potentially. Report and confirm each required location and reassignment before billing there.
Managing more than enrollment?
Run the rest of the clinic in one place.
Intelligent Clinic OS helps therapy practices manage scheduling, documentation, billing, eligibility, claims, and clinic operations.
Explore Intelligent Clinic OSEnrollment reviewed: August 23, 2026 · Reassignment reviewed: September 14, 2026
Enrollment rules change. Confirm current CMS and MAC guidance before acting.
Free educational tool only. Intelligent Clinic OS does not submit to CMS, provide legal advice, or determine whether a clinician is eligible to bill Medicare.