Revalidate My Enrollment

Table of Contents

• Step 1: Determine You Are in the Right Place
  • What’s ahead for your next Medicare enrollment revalidation?
  • How will you know if you are due for revalidation?
• Step 2: Complete the Medicare Application
• Step 3: Submit the Required Documentation
• Related Content

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Step 1: Determine You Are in the Right Place

Medicare provider enrollment revalidation is part of the Patient Protection and Affordable Care Act, Section 6401(a), which established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. CMS has completed its initial round of revalidations and will be resuming regular revalidation cycles in accordance with 42 CFR Section 424.515 Federal Register 2/2/2011 (CMS-6028-FC).

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What’s ahead for your next Medicare enrollment revalidation?

CMS has established due dates by which the provider/supplier’s revalidation enrollment application must reach the MAC in order for them to remain in compliance with Medicare’s provider enrollment requirements. The due dates will generally be on the last day of a month (for example, June 30, July 31 or August 31).

Submit your revalidation application to your MAC no more than seven months prior to your due date to avoid a hold on your Medicare payments and possible deactivation of your Medicare billing privileges. Generally, this due date will remain with the provider/supplier throughout subsequent revalidation cycles by adding five years to the determined date.

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How will you know if you are due for revalidation?

There are several ways to determine when you are due for revalidation:

1. Each enrollment will receive a revalidation request letter in a yellow envelope from your MAC.
   1. We will mail two request letters within two or three months prior to your revalidation due date. One to the special payments address and one to the correspondence address Medicare currently has on file. If both of those addresses are the same, the second letter will be mailed to one of the provider’s practice location addresses. If all three addresses are the same, only one letter will be mailed.
2. The Medicare Revalidation List Tool includes all enrolled providers/suppliers and due dates as they are determined. Those due for revalidation will display a revalidation due date, all other providers/suppliers will display a “TBD” (To Be Determined) in the due date field.

Note: Providers/suppliers who are within two months of their listed due dates on the CMS Revalidations web page but have not received a notice from National Government Services to revalidate, are encouraged to submit their revalidation application.

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Step 2: Complete the Medicare Application

Providers are to submit their CMS-855 revalidation enrollment applications no more than seven months prior to their due dates.

You can complete the enrollment application either electronically via Provider Enrollment Chain & Ownership System (PECOS) or on paper. Submitting the application electronically will result in a faster response than submitting by mail.

• To submit your application electronically, you will access PECOS. Here you will be able to become a registered user and gain access to the enrollment record to complete the electronic application. Select the My Associates button then select the appropriate enrollment and the system will guide you through the process.
• To submit your application by mail, you will fill out CMS-855A to revalidate and CMS-588 (instructions for completion are on the forms). When completed, mail provider enrollment applications and supporting documents to appropriate jurisdiction and area address.
  • MAC Contact List

Note: Read Understanding Authorized Official and Delegated Official Roles.

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Step 3: Submit the Required Documentation

It is imperative that you submit the proper documentation along with your enrollment application regarding your revalidation. Whether you chose to file electronically or on paper, you must prepare and submit documentation as follows:

• Online using PECOS: PECOS will generate a list of required supporting documentation that you can upload (PDF or TIFF) prior to submitting the application.
• CMS-855A paper form: See section 17 of the CMS-855A application to determine the required documentation.

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Related Content

• CMS.gov Revalidation Information
• Sample Revalidation Letter
• MLN Educational Tool® Medicare Provider Enrollment

Please share your thoughts about your experience with our enrollment process.

Revised 11/15/2024