Provider Enrollment: Resumed Revalidation Activities

Attention: Provider Enrollment and Credentialing Departments

Activities have resumed with revalidation due dates starting with 1/31/2022. Don’t wait to revalidate if CMS assigned a current due date.

Revalidate before your due date to avoid a hold on your Medicare payments and deactivation of your Medicare billing privileges.

There are several ways to find your revalidation due date:

• Medicare Revalidation List Tool
  • Search by NPI or name.
  • A due date of "TBD" (to be determined) means a revalidation due date has not been assigned by CMS.
  • Instructions on how to use the tool can be found under the article titled How to Search on the Medicare Revalidation List Tool for Due Date
• Revalidation notice mailed by National Government Services
  • Mailed in yellow envelope
  • Sample Revalidation Letter
• PECOS
  • Sign in with user ID and password.

IMPORTANT: If a current revalidation due date has not been assigned or if the due date is TBD, all unsolicited revalidation applications will be returned.

Revalidate Medicare enrollment information either electronically by using the Internet Based Provider Enrollment, Chain and Ownership System (PECOS) or by submitting the appropriate CMS-855 paper application. Find current forms on our website under Resources, and then select Forms.

Already submitted your revalidation application?

Find the status of your submitted application by using our Check Provider Enrollment Application Status Tool located on our website. Select Resources, and then select Tools & Calculators.

If status is “Approval Recommendation,” you’ll need to contact the state agency indicated in your approval recommendation letter. For more information view our article titled Understanding the Approval Recommendation Process for Certified Providers.

Don’t Forget to…

• Pay the application fee. Verify if you need to pay the fee by using the Medicare Provider Enrollment Application Fee Decision Tree Tool
• Have an authorized/delegated official of an organization or the individual provider sign and date the CMS form(s), include newly added authorized/delegated officials. (Signatures cannot be delegated to unauthorized personnel). See our article titled Understanding Authorized Official and Delegated Official Roles
• Include all required documentation, when applicable. (license, certifications, degrees, void check, Exhibit 177, sales agreement, capitalization, bill of sale).
• Verify LBN matches the IRS document, including any suffixes on the:
  • CMS application
  • Bank account
  • NPPES (NPI Numbers)
  • CMS-588 EFT form
  • State registration websites
• Submit both individual and group enrollment applications for a Sole Owned Group in PECOS.

Need assistance with Medicare enrollment? Part B Providers/Suppliers can register for provider enrollment webinars by clicking on EVENTS at the top of the NGS website.

The webinars below are available on our website:

• Provider Enrollment Revalidation Overview
• Provider Enrollment: Getting Access to PECOS
• Provider Enrollment: Submitting Revalidation via PECOS
• Submitting Revalidation via CMS-855B Paper Application for a Part B providers
• Submitting Revalidation via CMS-855I Paper Application for a Part B providers
• Let's Chat about Provider Enrollment Revalidation
• PECOS: View and Manage Reassignments through Group Enrollment
• PECOS: Manage Signatures and Additional Information Requests
• Provider Enrollment: Opioid Treatment Program

Posted 5/5/2023