Medicare Revalidation: Frequently Asked Questions
If you are a Medicare provider, you know that you must periodically revalidate your enrollment information with Medicare. This process can be a bit complicated, and we frequently receive revalidation questions from our clients.
Here are some frequently asked questions about revalidation along with answers that you may find helpful:
How often must I revalidate my Medicare enrollment record information? Revalidation is required every three or five years. The Centers for Medicare & Medicaid Services (CMS) will set every provider’s revalidation due date at the end of a month.
Where can I find my revalidation date? CMS posts upcoming revalidation dates 6 months in advance on their Medicare Revalidation List. A due date of “TBD” means that CMS has not yet set the date.
What is the deadline for revalidation? Revalidation applications must be submitted on the last day of the applicable month.
Will I receive any advance notice of the revalidation requirement? You will be notified directly by your Medicare Administrative Contractor (MAC). The notice will be sent 2-3 months before your revalidation due date.
Where will the MAC revalidation notice be sent? The notice will be sent to the email address reported on your prior application. If there is no email address, the notice will be mailed to at least 2 of your reported addresses; for example, your correspondence and primary practice addresses.
I am within 2 months of my listed due date but have not yet received a revalidation notice from my MAC; what should I do? We recommend that you go ahead and submit the revalidation application. But don’t submit the revalidation if you haven’t received the notice and your due date is not listed on the database.
I am a supplier of Durable Medical Equipment Prosthetic and Orthotic Supplies. Is the revalidation process the same for my practice? You will receive communications directly from the National Supplier Clearinghouse about your revalidation date.
How do I revalidate? The quickest and most efficient way is through the Medicare PECOS system where you can review current information, update and submit your revalidation and supporting documents and electronically sign the submission. You’ll find this CMS revalidation checklist very helpful.
What are the ramifications if I don’t revalidate by the appropriate due date? Please make every effort to do so, because if you miss the due date, you risk a hold on Medicare payments and even deactivation of Medicare billing privileges.
Learn more about revalidation in the CMS Revalidation FAQs.
Complicated? Confusing? Yes, it can be! Let our expert specialists handle all your enrollment requirements, including revalidation.
Let Us Manage All Your Payer Enrollment Services
If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.