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July 10, 2017

Provider Credentialing: Maintaining Your Enrollment

Currently, CMS is in Cycle 2 of the Provider Enrollment Revalidation process, which requires all providers and suppliers enrolled in Medicare to revalidate by either submitting an application through Internet-based PECOS or by completing a new CMS-855 application.

It is not uncommon for changes to occur within your practice outside of the revalidation process. Examples of changes include:

  • Adding or removing providers from a group
  • Address or suite changes
  • Updates to authorized officials
  • Physician/practitioner retirement

Please NOTE: Maintaining your enrollment in Medicare is SEPARATE from the revalidation process. Changes that occur in your practice must be reported to CMS within 30 days of the change occurring to avoid suspension of your billing privileges. If the changes you have to report happen to coincide with your established revalidation due date, they MUST be reported SEPARATE from the revalidation process.

If you need help with reporting changes in your practice, the Provider Enrollment Interactive Help Tool is available to help identify the sections of the application you will need to complete.

For additional information regarding the revalidation process, please refer to MLN Matters® SE1605External PDF.

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