Free Medicare (PECOS) Revalidation Calculator
Enter your provider or supplier type and the date your enrollment took effect or was last revalidated. See your estimated revalidation due date, a live countdown with the 90, 60 and 30 day marks, and when to expect the notice from your contractor.
This tool is informational only and is not legal advice. The Medicare Revalidation List and your contractor's notice have the final word on your due date.
Revalidation due date calculator
Most providers and suppliers revalidate every 5 years. DMEPOS suppliers revalidate every 3 years. The dates and timing below come from the CMS enrollment regulations and the CMS revalidation page.
Pick the type and enter the date.
What happens if you miss it
CMS can deactivate your Medicare billing privileges if you do not send complete information within 90 days of the revalidation notice, and the deactivation can be dated back to when you fell out of compliance (42 CFR 424.540(a)(3) and (d)). While you are deactivated, Medicare pays nothing for the services you furnish, the patient owes nothing for them, and anything you collected from the patient has to be refunded (42 CFR 424.555(b)). Getting back in means recertifying your enrollment, and CMS can require a complete new CMS-855 application. Reactivation takes effect on the date your contractor receives the submission it approves, so the days in between are not paid (42 CFR 424.540(b) and (d)(2)). CMS also warns that a late revalidation can bring a hold on your Medicare payments (CMS).
Questions
Why is the due date an estimate?
CMS sets the actual due date and posts it on the Medicare Revalidation List seven months ahead. The calculator adds the cycle length to the date you enter, which is how the regulations describe the cycle. If the list shows a different date, the list wins. CMS can also ask for a revalidation off cycle.
Which date should I enter?
The date your enrollment took effect, or the date your last revalidation was approved, whichever is later. A DMEPOS supplier revalidates 3 years after billing privileges were first granted or 3 years after its last revalidation. Everyone else enters a 5-year cycle once a completed application is submitted and validated.
When will the revalidation notice come?
CMS says your enrollment contractor sends it by email or mail about three to four months before the due date. Medicare Administrative Contractors send them to providers, groups and suppliers other than DMEPOS. The National Provider Enrollment East and West contractors send them to DMEPOS suppliers. You are responsible for the date whether or not a notice arrives.
Can I revalidate early, or get more time?
If the due date is more than seven months away and you have no notice, CMS returns the application unsolicited. Within three months of the due date, CMS says to revalidate even without a notice. CMS does not grant extensions, and there are no exemptions.
What about ambulance suppliers?
The revalidation rule sends ambulance suppliers to a separate rule that has them resubmit when the contractor asks. CMS says providers and suppliers generally revalidate every five years, so the calculator uses five years as the estimate. Go by the Medicare Revalidation List and your contractor's letter.
Sources: 42 CFR 424.515, the 5-year cycle, the CMS notice and the 60-day window; 42 CFR 424.57(g), the 3-year DMEPOS cycle; 42 CFR 410.41(c)(2), ambulance suppliers; 42 CFR 424.540, deactivation and reactivation; 42 CFR 424.555(b), no payment while deactivated; CMS, Revalidations (Renewing Your Enrollment), due dates, notices and timing.
Already late? Read Missed Your Medicare Revalidation Due Date? What Happens Next. For why applications come back, see PECOS Returned for Corrections.
Revalidations get denied for the same enrollment errors the pre-check catches.
The PECOS Medicare Enrollment Pre-Check reads a draft CMS-855I, 855B or 855S before it goes into PECOS. It checks the NPI and taxonomy against NPPES, the legal name against the IRS name, ZIP+4 addresses, expiring credentials and the supporting documents. $25.00 per completed pre-check, with free sample runs on the page.
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