US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)
Maintaining enrollment: reporting changes, revalidation, documentation, skilled nursing facility disclosures (424.515 to 424.516) – US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P)

US Medicare Provider and Supplier Enrollment (42 CFR Part 424 Subpart P) 424.515: Revalidate enrollment every 5 years (every 3 years for DMEPOS suppliers) by submitting the complete application and documentation within 60 days of the CMS notice, and respond to off-cycle revalidation and site visits when CMS requires them

What does 424.515 require?

To maintain billing privileges a provider or supplier other than a DMEPOS supplier must resubmit and recertify the accuracy of its enrollment information every 5 years (ambulance suppliers under 410.41(c)(2), DMEPOS suppliers renewing every 3 years under 424.57(g)); CMS contacts each provider when revalidation is due and the provider must submit the applicable application with complete and accurate information and supporting documentation within 60 calendar days of the notice, meeting all the submission, content, signature, verification, operational and inspection requirements of 424.510. No new certification or provider agreement is needed for revalidation, but Part 488 and 489 requirements continue; CMS may perform onsite inspections, may require off-cycle revalidation (with or without a site visit) triggered by random checks, local fraud problems, national initiatives, complaints or other concerns, and may change the routine cycle for a provider type with 90 days' notice; all revalidations are screened under 424.518.

Maintained by Gerard Blokdyk

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