Please Note: Effective October 1st, 2021, CMS will restart Medicare revalidations for providers and supplies. Prior to this, revalidations were put on hold due to the COVID health emergency. To determine if you have an pending or upcoming provider revalidation you can utilize Medicare’s Revalidation List online. medicare revalidation lookup.
As a leader in your practice, it’s imperative that you know when your providers’ Medicare revalidations are due. To do this you must get a handle on how Medicare sets its revalidation due dates and know where to find them.
Missing a Medicare revalidation deadline can get your practice excluded as an approved Medicare provider, which can significantly reduce your revenue. However, with a little bit of help, you can master Medicare’s revalidation guidelines and lookup tool to stay ahead of deadlines and keep your Medicare reimbursements flowing.
When is Your Medicare Revalidation Due? medicare revalidation lookup.
Medicare utilizes two cycles to manage its revalidations:
- Providers are on a five-year schedule
- Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) are on a three-year schedule
You can calculate your revalidation deadline based on the date of your initial enrollment as a Medicare provider or your last successful revalidation (whichever is more recent). So, if you enrolled and haven’t yet had a revalidation, it will be due five years from the date of your enrollment. If you’ve had a revalidation, your next one will be due on the same date in five years.
Once you’ve completed your revalidation, CMS mandates that revalidations are due on the last day of the month. For example, if you have a September revalidation deadline, you must have it completed and submitted by the 30th of that month.
To give you a little breathing space, the Agency posts due dates online six to seven months in advance. Previously, you had to submit your provider’s revalidation within 60 days of the date on the revalidation letter from the Medicare Administrative Contractor (MAC). Now, the MAC sends revalidation notices 90 to 105 days before a revalidation due date – by mail or email.
When you view a revalidation online, the site has options to display all your enrolled providers and suppliers. Remember – each of your providers and suppliers will have a unique revalidation date. If a revalidation is due within the next six to seven months, you’ll see a date online. If there’s no revalidation due within that timeframe, “TBD” will be displayed in the due date field.
Medicare’s Revalidation Lookup Tool
The Medicare Revalidation Lookup tool includes useful searches you can utilize to make the revalidation process easier. You can search by:
- Organization
- National Provider Identifier (NPI)
- First or last name of a practitioner
- Group records and reassigned members
Other functionalities allow you to:
- Download an entire list of providers and suppliers and apply filtering options
- View a crosswalk to the organization(s) your individual practitioners reassign benefits to
You can find the Lookup Tool and additional information on Medicare’s website.
IMPORTANT: The Medicare Revalidation Lookup tool will continue to show the due date even after the revalidation has been completed or the due date has passed unless your provider has been deactivated or terminated. CMS has added language to the front page of the website to show when the information was last updated and the next tentatively scheduled update.
Get the expert advice that you need to better manage your Medicare revalidations with a variety of expert-led online trainings immediately available to you.
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