Revalidation

The periodic process of updating and re-verifying a provider's Medicare enrollment to ensure their information is current and they continue to meet enrollment requirements.

Revalidation is Medicare's version of re-credentialing. Every Medicare-enrolled provider must revalidate their enrollment every five years. DMEPOS suppliers must revalidate every three years. CMS notifies you when your revalidation is due, and you have a specific window to complete it. The revalidation process involves logging into PECOS, reviewing all your enrollment information, updating anything that has changed, and resubmitting your application. It is essentially the same as your initial enrollment, but you are confirming that all your existing information is still accurate. If you miss the revalidation deadline, CMS deactivates your Medicare billing privileges. This means any claims you submit after deactivation will be denied. You can reactivate by completing the revalidation, but there may be a gap during which you cannot bill Medicare. CMS sends revalidation notices to the correspondence address on your PECOS file. If your address is outdated, you might never get the notice. This is one of the most common reasons providers miss revalidation, they simply did not know it was due because the notice went to an old address. Make sure your PECOS correspondence address is current and monitored. Set a calendar reminder for your revalidation due date. Do not wait until the last minute, give yourself at least 60 days to complete the process in case there are issues or requests for additional information from your MAC. Revalidation is also a good time to clean up your Medicare enrollment. Update practice locations, remove old addresses, verify your specialty and taxonomy codes, and make sure your reassignment of benefits is correct. Think of it as a five-year checkup for your Medicare participation.