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Medicare revalidation is one of the most misunderstood aspects of Medicare participation. Get it wrong and CMS deactivates your billing privileges. Here is everything you need to know about the current revalidation process and 2026 updates.

What Is Medicare Revalidation?

Revalidation requires all enrolled Medicare providers to periodically verify that their enrollment information is still current and accurate. Under current CMS policy, most physicians and non-physician practitioners revalidate every 5 years. High-risk provider types revalidate every 3 years.

How CMS Notifies You in 2026

CMS now sends notices via email to the address registered in PECOS (if on file), physical mail to the PECOS correspondence address, and as a notification on your PECOS dashboard when you log in. The most common reason providers miss revalidation notices: outdated mailing address, no email address on file, or both.

What Happens When You Miss the Deadline

  1. CMS deactivates your Medicare billing privileges
  2. Claims submitted after the deactivation date are denied
  3. There is no retroactive billing right for revalidation-related deactivation. You cannot bill for services provided during the deactivation period even after completing revalidation
  4. You must submit a full revalidation to reactivate, which takes 30 to 60 days

Financial exposure: A revalidation lapse can easily exceed $50,000 to $200,000 for a busy practice depending on patient volume and how long the deactivation goes undetected.

How to Check Your Due Date Right Now

  1. Go to pecos.cms.hhs.gov and log in
  2. Navigate to your enrollment record
  3. Find the Revalidation Due Date field in your enrollment summary
  4. Alternatively, call 1-855-267-1515 and ask for your revalidation status

2025-Specific Revalidation Requirements

Do Not Let Revalidation Catch You Off Guard

We track revalidation due dates for all clients and initiate the process 120 days before each deadline, with enough buffer that a slow approval never results in a billing gap.

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JR

James Reyes, CPC

Senior Credentialing Specialist with 15+ years of experience navigating state Medicaid portals, Medicare PECOS, and commercial payer panels. Certified Professional Coder (CPC) dedicated to eliminating revenue cycle bottlenecks.