CMS Announces Provider Enrollment Revalidation Requirements

The Centers for Medicare and & Medicaid Services (CMS) has released information about the requirements for providers to enroll in revalidation cycle 2 to maintain Medicare billing privileges.

In accordance with 42 CFR §424.515, a provider must resubmit and recertify the accuracy of their enrollment information generally every 5 years. Revalidation ensures that a provider’s enrollment information on file with Medicare remains complete and up-to-date.

Medicare providers who are due for revalidation are being encouraged to submit their application within 6 months of their due date or whenever they receive notification from their Medicare Administrative Contractors to revalidate.

If a provider fails to revalidate at the proper time, their enrollment is deactivated and Medicare claim payments will not be made. Deactivation also impacts a provider’s ability to order, certify and prescribe.

CMS is currently defining the due date based on the last time the provider initially enrolled or revalidated, but some providers may be asked to revalidate in advance of the 5-year cycle. CMS reserves the right to conduct off-cycle revalidations in accordance with 42 CFR §424.515.

Click here to view the MLN article that covers revalidation cycle 2. And, to view a list of frequently asked questions, click here.



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