• Before You Begin
  • Complete Agency Form
  • Enter Payment Info
  • Review & Submit
  • Confirmation

You must use the CMS Provider Enrollment, Chain and Ownership System (PECOS) website to pay this fee. Select Continue to Form to be presented one option for accessing the PECOS website. For all questions please call: 1-866-484-8049.

Accepted Payment Methods:

  • Bank account (ACH)
  • Debit or credit card

This is a secure service provided by United States Department of the Treasury. The information you will enter will remain private. Please review our privacy policy for more information.

Contact:
the PECOS help desk