Billing / Fees / Insurance

Medicare HETS EDI Enrollment Requirement – Effective May 11, 2026

Samuel A. Collins  |  DIGITAL EXCLUSIVE

The Centers for Medicare & Medicaid Services (CMS) is implementing a new HETS Trading Partner Management System (TPMS) effective May 11, 2026.

All providers and suppliers (including doctors of chiropractic) must complete HETS EDI (HIPAA Eligibility Transaction System Electronic Data Interchange) attestation and enrollment to maintain the ability to electronically verify Medicare beneficiary eligibility. 

  • HETS is used to verify Medicare Part B (fee-for-service) eligibility via 270/271 transactions.
  • This requirement does not apply to Medicare Advantage (Part C) plans.
  • Claims submission (837 transactions) is not affected.
  • Each provider mus attest individually and link each NPI to their clearinghouse/vendor using the HETS Submitter ID. This linkage is no longer automatic, even for existing vendor relationships.

Failure to complete enrollment will result in rejection of eligibility transactions and loss of real-time Medicare eligibility verification.

Click here for enrollment instructions.

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