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The federal regulation at 42 CFR § 455.414 requires that state Medicaid agencies revalidate the enrollment of all providers, regardless of provider types and/or specialties, at least every 5 years.
When revalidating businesses (EIN enrollment) that have more than one service location, a separate revalidation for each different location is required.
If a fee is required, it is applicable to each service location. Please review the specialty information below to determine if the fee is required.
Individuals (SSN enrollment) complete only one revalidation.
Note: New specialties are not available to be added during a revalidation. If applicable they can be added via a maintenance request once revalidation is finalized and approved.
Before beginning a revalidation through the Provider Portal, please take a minute to review the:
After reviewing the training materials, log into the Provider Web Portal to begin revalidation.
RISK LEVEL
Each specialty is designated as low, moderate, or high risk.
FEE REQ’D?
The specialty indicates if a fee is required by federal or state regulation.
NPI REQ’D?
The specialty is required to have a National Provider Identifier (NPI).
TAX ID REQ’D?
The specialty allows a business using a federal Employer Identification Number (EIN), or an individual using a Social Security Number (SSN).
OOS ALLOWED?
(Out-of-state (OOS) enrollment allowed?) The specialty allows for out-of-state service locations.
BT ALLOWED?
(Border town (BT) enrollment allowed?) the specialty allows the service location to be in an approved border town. Please see Appendix F for a list of approved border towns.
Each business (EIN enrollment) service location must complete a separate revalidation.
Each service location must complete a separate revalidation.
Each business (EIN enrollment) service location must complete a separate revalidation and pay a separate fee.
For businesses other than sole-proprietors, the enrolling provider must submit a statement on letterhead attesting that the provider is the only person who will be providing services, and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license for each employee. The provider must sign either attestation.
EIN enrollments - Home Care Agency Class A license or Hospice license is optional.
Insurance (attach a copy of current insurance and complete the insurance information in revalidation)
If enrolled via an SSN rather than an EIN, please do not pay the revalidation fee (just continue on to the next page of revalidation.)
Approval from the Colorado Department of Public Health and Environment.
AHCB Hippotherapy Certification or Hippotherapy Clinical Specialist Certification
Board Certified Music Therapist certification or Dance Therapy certification (attach a copy of the certificate and complete the information in revalidation)
License (attach a copy of current license and complete the license information in revalidation) for each individual providing services
License (attach a copy of current license and complete the license information in revalidation)
For businesses other than sole-proprietors, the provider must submit a statement on letterhead attesting that the provider is the only person who will be providing services and that he/she will not be hiring others to provide these services. If the provider will have employees providing services, the provider must submit a list of staff and attach a copy of the current license for each employee. The provider must sign either attestation.
Assisted Living License from CDPHE (attach a copy of current license and complete the license information in revalidation)
Certification (attach a copy of current CDPHE Supported Living Program certification)
Commission on Rehabilitation Counselor Certification
Insurance (attach a copy of current insurance and complete the insurance information in revalidation.
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