PECOS file and layout
Used by Homecare, the Ordering and Certifying Physician file can only be downloaded from this location: https://data.cms.gov/Medicare-Enrollment/Order-and-Referring/qcn7-gc3g. The file is updated twice weekly by CMS.
The file includes information used to identify the provider and the status of their enrollment in various Medicare programs. The file contents are as follows:
- NPI
- Last Name
- First Name
- Part B
- DME
- HHA
- PMD
- Hospice - Effective April 1, 2024
It is possible for the provider to certify for some specialties but not all. For this reason, the billing rule and order changes for home health were updated to look at the value in the HHA column. Effective May 1, 2024, physicians must be enrolled in PECOS to order and certify hospice benefit periods. This is applicable to the designated attending physician and the hospice physician. Nurse practitioners and/or physician assistants who are identified as a designated attending provider for a hospice patient are not mandated to be enrolled in PECOS.