Revalidation of Medicare Enrollment

The Medicare provider compulsory revalidation period has been extended to 2015. Until 2015 Medicare Carriers and Contractors will be sending out notices on a regular basis to providers who enrolled in Medicare before March 25, 2011.

All providers who enrolled with Medicare prior to March 25, 2011, will be required to revalidate their Medicare enrollment by submitting the appropriate CMS-855 Medicare enrollment form(s) to their Medicare contractor in response to notices sent between September, 2011, and March, 2015. This requirement for revalidation is based on Section 6401 of the Patient Protection and Affordable Care Act., which also requires that all providers be reevaluated under the screening guidelines established in Section 6028 of the law. Providers have 60 days from the date of the revalidation notice to submit their complete enrollment information or they will be dropped from the Medicare enrollment rolls. 

Providers are to submit their CMS-855 revalidation enrollment applications only after receiving notification that they are required to do so. Notification letters are being sent out by Medicare Administrative Contrctors on a regular, intermittent basis. 

The initial, Phase 1, revalidation notices were sent in September 2011 to providers who did not have complete information in the Provider Enrollment, Chain & Ownership System (PECOS). Revalidation mailings will continue to be sent on an ongoing basis until March 2015. The names and National Provider Numbers of the providers who have been sent revalidation notices are listed, by mailing date, in the Downloads section of the Centers for Medicare & Medicaid Services' Revalidations website [External Link]. 

Revalidation notices are mailed simultaneously to the provider's primary special payments address and correspondence address. Providers must submit revalidation applications for all provider transaction access numbers (PTANs) reported on the revalidation notice.