Medicare Revalidation

What Does it Mean When Medicare Sends a Letter to Revalidate?

Once again, Medicare is asking providers to revalidate already existing information for their PTAN to remain in effect. So what now… Do you have to just send in your license or do you have to resend everything again like you did when you first applied?

Unfortunately, you have to do the latter, which is to resend all the applications again as if you were a new provider in order revalidate your PTAN. The only difference is on the CMS-855I Medicare application and the CMS-855B Medicare application should check Revalidation in section 1A instead of New Enrollment to indicate the application is being submitted to revalidate the group or individual provider. Providers that reassign their benefits to the group should submit the 855I and 855R as part of the revalidation process for the group.

The CMS-588 Electronic Funds Medicare application only has to be submitted if the group is not receiving payments electronically.

The CMS-460 Medicare Participating Physician or Supplier Agreement application does not need to be submitted because revalidation does not  affect the current participation status of providers.
After you have had all parties sign and date the applications make a copy in case you are asked to change or resubmit any information regarding the application. It’s easier to work from an existing application than to try and remember what you sent in on the first application.

Pecos is also another option but one I don’t use because I’ve encountered a lot of problems when I did try to use it. I also find it to be a very difficult system to navigate; the customer service on how to navigate the system is nonexistent. But that is for another blog….

Lastly, do not forget to send in a copy of the Medicare Revalidation letter you received with the application. The letter is the only way Medicare has of tracking the group application and applying the information to the correct request for revalidation.

For more information on how to do this and other forms of credentialing please visit my website at for a full price list and detailed outline of different costs for the best way to credential, which is to have a specialist do it right the first time. You can also call me at (314) 440-1244.

Best regards,
Carolyn Wilkinson



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