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National Provider Enrollment Revocations & Reinstatements

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  1. What happens when National Provider Enrollment (NPE) East or West revokes my Medicare Provider Number billing privileges?

    • When an NPE contractor (East or West) revokes your Medicare billing privileges, the claims processing system will automatically deny new claim submissions. The denial reason will state, “not certified/eligible to be paid for this procedure/service on this date of service.”

      The system will also automatically adjust previously paid claims and generate overpayments for any dates of service that fall within the revocation period.

      This is a system-driven process and is not controlled by the DME MAC. The DME MAC also does not have authority to reinstate a provider’s Medicare privileges.

      Originally published: 04.09.2026

  2. What should I do if my provider number is revoked?

    • You must work directly with your NPE contractor (East or West). You may also appeal the revocation decision through the NPE Appeals and Rebuttals Contractor (ARC), which is Chags Health Information Technology LLC (C‑HIT).

      Appeal rights, including information that explains providers’ rights following CMS determinations related to Medicare enrollment requirements, are outlined in 42 CFR Part 405 Subpart H – Appeals Under the Medicare Part B ProgramExternal website (42 CFR 405.800-405.818).

      You are responsible for providing documentation to C‑HIT proving compliance with CMS Provider Enrollment Guidelines as specified in 42 CFR § 424.57External website .

      You must submit an appeal reconsideration request within 65 days of the initial NPE determination letter.

      This is an appeal of the NPE Revocation, not an appeal of an individual overpayment claim.

      Appeals & Rebuttal Contractor (C‑HIT) Contact Information:
      Chags Health Information Technology, LLC (C‑HIT)
      CMS Provider Enrollment Appeals & Rebuttals
      P.O. Box 45266
      Jacksonville, FL 32232
      Phone: 800‑245‑9206
      Fax: 866‑410‑7404
      Email: PEARC@c-hit.com

      Originally published: 04.09.2026

  3. What if I disagree with the C HIT reconsideration decision?

    • If you believe the C‑HIT decision is incorrect, you may request Administrative Law Judge (ALJ) review.

      You must file your ALJ appeal with the Civil Remedies Division of the Departmental Appeals Board (DAB) within 60 calendar days of receiving the decision.

      Originally published: 04.09.2026

  4. How do I file a DAB hearing request?
  5. If my revocation appeal is overturned with a favorable decision, what happens next?

    • C‑HIT will notify the NPE of the final decision. The NPE may take up to 10 business days to reinstate your Medicare provider number in the system.

      After the number is reinstated:

      • The DME MAC will automatically reverse any overpayments generated due to the revocation.
      • This process may take up to 30 days.
      • Refunds will be issued for any collections or recoupments taken from the provider or beneficiary.
      • If your debt was referred to Treasury, it will be automatically recalled.

      Originally published: 04.09.2026

  6. Do I need to resubmit claims after I receive a favorable appeal decision?

    • No. The DME MAC will automatically reopen and reprocess all claims that were previously denied with denial reason “not certified/eligible to be paid for this procedure/service on this date of service.”

      Resubmitting claims may create delays and could result in additional overpayments. Providers should allow time for the automated process to be completed.

      Originally published: 04.09.2026

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