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Medicare Credentialing

Everything You Need to Know About Medicare Enrollment

Medicare credentialing is how CMS verifies that you're qualified to treat Medicare beneficiaries and bill for services. We make the process fast and painless.

What Is Medicare Credentialing?

Medicare credentialing is the process the Centers for Medicare & Medicaid Services (CMS) uses to verify that a healthcare provider — such as a doctor, practice, or clinic — is qualified to treat Medicare beneficiaries. CMS checks your licensure, education, training, and professional background before approving you to bill Medicare for patient services. Without credentialing, you cannot receive reimbursement for Medicare patients.

How Long Does It Take?

CMS quotes a typical processing time of 90–120 days. However, our team is usually able to get approval letters issued in approximately 50 days thanks to meticulous application preparation and proactive follow-up. A 30-day retroactive effective date is issued from the date the application was submitted, meaning you can bill for services rendered during the waiting period.

PECOS & Primary Source Verification

All Medicare enrollment is done through PECOS (Provider Enrollment, Chain, and Ownership System), CMS's online enrollment portal. We handle your complete PECOS registration, ensure all required fields are accurate, and manage the primary source verification process — confirming your credentials directly with issuing institutions. Errors in PECOS submissions are the #1 cause of delays, and we eliminate that risk.

Retroactive Billing & Effective Dates

One of Medicare's biggest advantages for new providers: CMS grants a 30-day retroactive effective date from the date your application was submitted. This means if your application is submitted on day one and approved on day 50, you can still bill for any Medicare patients you saw during those 50 days (within the 30-day retroactive window). We submit applications as fast as possible — often the same day — to maximize your retroactive billing window.

Medicare At A Glance

Administering AgencyCMS (Federal)
Enrollment PortalPECOS
Standard Timeline90–120 days
Rush Accelerated~50 days
Retroactive Date30 days from submission
RecredentialingEvery 5 years
Beneficiaries65M+ Americans

Every day you wait is a day of lost Medicare revenue. Let us get you enrolled fast.

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Requirements

What You Need for Medicare Credentialing

We'll walk you through everything during your free consultation. Here's what CMS typically requires.

Active State License

Current, unrestricted professional license in the state where you'll practice.

NPI Number

Your National Provider Identifier (Type 1 for individuals, Type 2 for organizations).

Malpractice Insurance

Proof of current professional liability / malpractice coverage.

DEA Registration

If applicable to your specialty — required for providers who prescribe controlled substances.

Education & Training

Documentation of your medical education, residency, fellowships, and board certifications.

Work History

Complete employment history for the past 5 years with no unexplained gaps.

How It Works

From Application to Medicare Approval in 4 Steps

We manage the entire Medicare enrollment journey so you can focus on patient care.

1

Free Consultation

We discuss your Medicare enrollment needs, timeline, and specialty requirements.

2

We Handle PECOS

We complete your PECOS registration, fill out all CMS forms, and submit your application — often the same day.

3

Monitor & Follow Up

We track your application status with CMS, respond to any requests, and push for accelerated processing.

4

You're Approved

You receive your Medicare approval letter and can bill for services — including the 30-day retroactive window.

Testimonials

Trusted by Providers Nationwide

★★★★★

"Rush Credentialing is truly unmatched! Landon has been an incredible partner in expediting credentialing for both my business and therapists across multiple disciplines."

Jenny Vincent
Practice Owner
★★★★★

"Landon and his team are great to work with!! They are responsive, competitively priced, friendly, professional, and most important, they know what they are doing."

Michael Boas
Healthcare Provider
★★★★★

"I had an incredible experience working with Rush Credentialing. Landon was knowledgeable, responsive, and made the entire process of getting credentialed with Medicare seamless."

TJ Retuya
Healthcare Provider
More Insurances

We Also Credential With These Networks

Need more than Medicare? We handle credentialing with every major insurance in the country.

Common Questions

Medicare Credentialing FAQ

CMS officially quotes 90–120 days for Medicare enrollment. However, our accelerated process typically achieves approval in approximately 50 days. We submit applications the same day when possible and follow up proactively with CMS to avoid delays. Plus, Medicare grants a 30-day retroactive effective date, so you can bill for patients seen during the waiting period.
When CMS approves your Medicare enrollment, they issue an effective date that goes back 30 days from the date your application was submitted. This means if you started seeing Medicare patients after submitting your application, you can retroactively bill for those services within that 30-day window. This is why same-day submission matters — the sooner we submit, the sooner your retroactive window begins.
PECOS (Provider Enrollment, Chain, and Ownership System) is CMS's online portal for Medicare provider enrollment. All Medicare credentialing applications go through PECOS. You do not need to register yourself — we handle the entire PECOS submission process on your behalf, ensuring all fields are completed accurately to avoid the delays that commonly result from errors or missing information.
Absolutely. In fact, this is the most efficient approach. We can submit your Medicare enrollment through PECOS while simultaneously submitting applications to Aetna, Cigna, UHC, BCBS, Optum, Humana, TRICARE, and any other insurances you want — all at the same time. This way, you're getting in-network with every payer as quickly as possible.
Medicare requires providers to revalidate their enrollment every 5 years (or 3 years for DMEPOS suppliers). Missing a revalidation deadline can result in deactivation of your Medicare billing privileges. We can manage your revalidation cycle so you never risk losing your Medicare enrollment status.
Every day without Medicare = lost revenue

Ready to Get Medicare Credentialed?

Stop losing Medicare patients. Get your free, no-obligation quote and we'll have your PECOS application submitted within days.

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