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Provider Revalidation Fact Sheet for Congressional Field Offices

The Affordable Care Act, Section 6401 (a), requires enrolled providers to revalidate their Medicare enrollment every five years, and enrolled durable medical equipment suppliers to revalidate every three years. (Reference 42 CFR 424.515). The second five-year revalidation cycle began in March 2016 for all currently enrolled providers/suppliers.

How Will You Know it is Time To Revalidate?

The CMS will post the provider/supplier’s revalidation due date on the Medicare Revalidation List tool.

National Government Services will notify our providers/suppliers by letter when they are scheduled to revalidate. The letter may include the following information:

  • Due date
  • Provider name
  • National Provider Identifier (NPI) and Provider Transaction Access Number (PTAN) combination
  • Legal business name/doing business as (DBA) name
  • State
  • Tax ID (last four digits)

View the revalidation envelope or letter samples.

Can a Change in Information for an Enrollment Wait Until Revalidation?

The revalidation process does not change or alter normal provider enrollment laws for Medicare. You cannot wait for revalidation to update your enrollment record; it is not in compliance with Medicare regulation.

You must report changes of information in your Medicare enrollment records within 30 days for:

  • Change(s) in reassignments or employee arrangements
  • Change(s) in bank account information
  • Change(s) in ownership
  • Change(s) in an authorized or delegated official
  • Change(s) in practice location
  • Final adverse legal action(s)

  • IDTF supplier change(s) in general supervision

  • MDPP supplier change(s) in coach roster

All other changes to your existing Medicare enrollment records must be reported within 90 days.

How Does a Provider/Supplier Revalidate Their Enrollment?

The most efficient way to submit your revalidation information is by using PECOS or complete and submit the appropriate CMS paper application (CMS-855A, CMS-855B, CMS-855I or CMS-20134). Mail the paper application to the address indicated on the revalidation letter. Current copies of the applications are available on our website by selecting Enrollment and then Enrollment Forms.

Use the Revalidation Application Checklist to ensure you have included all information in your revalidation application

While processing the application(s), NGS may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days from the initial development letter date or claims payment will be impacted. If you do not respond within the 30 days, your PTAN may be deactivated.

If deactivated, you must submit a new and complete application to reactivate. You will maintain original PTAN, receive a new effective date and have a gap in billing privileges.

Does the Application Fee Apply to Revalidation?

The application fee is required during revalidation for select provider types.

If you are one of the provider types listed below you must pay the application fee via the Medicare Application Fee Information page. Submit a copy of your payment receipt with the application.

  • Ambulance service suppliers
  • Ambulatory surgical center (ASC)
  • Community mental health center
  • Competitive Acquisition Program (CAP)/Part B Drug Vendor
  • Comprehensive Outpatient Rehabilitation Facility
  • Critical access hospital (CAH)
  • Durable medical equipment, prosthetic, orthotic and supplies (DMEPOS)
  • End-stage renal disease (ESRD) facility
  • Federally qualified health center (FQHC)
  • Histocompatibility Laboratory
  • Home health agency (HHA)
  • Home Infusion Therapy (HIT)
  • Hospice
  • Hospital
  • Independent Clinical Laboratory (CLIA)
  • IDTF
  • Indian Health Services Facility
  • Intensive Cardiac Rehabilitation (ICR)
  • Mammography Center
  • Mass Immunization (Roster Biller Only)
  • Opioid Treatment Program (OTP)
  • Organ Procurement Organization
  • Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services Provider that Enrolls and Bills Part A/CMS-855A
  • Pharmacy
  • Portable X-ray Supplier
  • Radiation Therapy Center
  • Religion Nonmedical Health Care Institution
  • Rural health clinic (RHC)
  • Skilled nursing facility (SNF)

Visit our website under the Enrollment tab for more information about the application fee.

What if a Provider/Supplier Has Additional Questions Regarding Revalidation?

Visit our website, select the Enrollment tab then Revalidate My Enrollment for detailed information.

Please contact NGS with questions specific to your revalidation application processing.

  • J6 Part A, FQHC and HHH: 855-834-5596
  • J6 Part B: 877-908-8476
  • JK Part A, FQHC and HHH: 855-593-8047
  • JK Part B: 888-379-3807

Questions specific to DME, prosthetic, orthotic and supply suppliers should be addressed to the National Supplier Clearinghouse, select state for DME contractors contact information. 

Questions specific to PECOS system issues should be addressed to the CMS EUS Help Desk at:

  • Toll-Free Telephone: 866-484-8049
  • Email

Revised 3/15/2024