A Couple of Notes on the PECOS File
CMS released its searchable PECOS database, complete with the names of physicians and non-physician practitioners registered
ATLANTA — CMS released its searchable PECOS database Jan. 28, complete with the names of physicians and non-physician practitioners registered in the Physician Enrollment, Chain and Ownership System — approximately 800,000 of them.
The alphabetical list includes the last name-first name and NPI of PECOS-enrolled physicians and other sources eligible to order and refer under Medicare. (For the complete CMS notice, see CMS Releases PECOS File, Jan. 28.)
But according to industry consultant Andrea Stark of MiraVista, Columbia, S.C., there’s good news and bad news about the file. The good news: Providers now have a way to compare their referral sources against the list. The bad news: Since the file is in a PDF format, “there is no easy way to narrow down, filter or otherwise sort through the nearly 800,000 records.”
The file is 16.63 MB in size, said Stark, and has 13,653 pages. “Due to the size of the file, download times may range anywhere from 42 seconds to 42-plus minutes, depending on the speed of your Internet connection,” she said, noting that it took her company approximately one-and-a-half minutes to complete the download.
The file is available on the “Ordering and Referring Provider” page on the Medicare Web site at: www.cms.hhs.gov/MedicareProviderSupEnroll.
A tip from Stark: “Once your download is complete, be sure to save the file to a specific location on your computer so you don’t have to re-download later.”
Providers should keep in mind, Stark said, that the list is a work in progress and will be updated/replaced monthly. She also pointed out that because of the time it takes contractors to review a physician’s PECOS enrollment application, typically 45 to 60 days, “newly enrolling physicians may not be included in the searchable list until two or even three months after they submit their application.”
In another note on the file, during an Open Door Forum call Jan. 20, a CMS official insisted “220” NPIs had been added to the file, even on questioning from callers. But a Jan. 28 message from the Common Electronic Data Interchange said CMS had added “approximately 220,000” NPIs to the existing PECOS records of those eligible to order/refer. “With this update to the PECOS records, CEDI has seen a drop in the number of warning messages being produced” on providers’ claims, the message said.
Beginning April 5, DMEPOS claims will reject if the ordering/referring physician or practitioner is not registered in PECOS.
For questions, providers can contact their DME MACs:
- Jurisdiction A – 866/590-6731
- Jurisdiction B – 866/590-6727
- Jurisdiction C – 866/238-9650
- Jurisdiction D – 866/243-7272
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