Revalidation Information for Home & Community-Based Services (HCBS) Providers

Instructions for HCBS Providers

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. 

Terms and Definitions

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.

HCBS Service Provided