Jump to navigation
The federal regulation at 42 CFR § 455.414 requires that state Medicaid agencies revalidate the enrollment of all providers, regardless of provider types, 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 Provider Type information below to determine if the fee is required.
Individuals (SSN enrollment) complete only one revalidation regardless of the number of affiliated groups. (If an individual MD, nurse, PA, PT, etc., is revalidated by an authorized agent, only one revalidation can be completed.)
Waiver service providers select the Home and Community-Based Services (HCBS) provider type for revalidation requirements.
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.
Each provider type is designated low, moderate, or high risk.
The provider type is required to pay a fee as required by Federal regulation.
The provider is required to have a National Provider Identifier (NPI).
The provider type is required to be an approved Medicare provider.
(Out-of-state (OOS) enrollment allowed?) The provider type allows for out-of-state service locations.
(Border town (BT) enrollment allowed?) the provider type allows the service location to be in an approved border town. Please see Appendix F for a list of approved border towns.
Click on the provider types below for more revalidation details.
Each service location must complete a separate revalidation
Copy of the license of the dentist or dental hygienist who owns the clinic, or copy of the Certificate of Good Standing issued by the Colorado Secretary of State if owned by a non-profit corporation.
Copy of the individual license for the MD, DO, OD or DPM who is affiliated to the clinic
Copy of the individual license for the Physician, Osteopath, Licensed Behavioral Health Clinician, or Licensed Psychologist who is affiliated to the clinic.
THIS PROVIDER TYPE IS NO LONGER AVAILABLE FOR ENROLLMENTS. Family planning services currently may be provided under the Clinic – Practitioner or Non-Physician Practitioner – Group, provider types. Please review those provider type requirements to select the appropriate entity based on your credentialed professionals.
Copy of the individual license/certification/attestation form for the individual provider who is affiliated to the group. (Acceptable licenses include: Behavioral Health Clinician, Psychologist, Nurse Practitioner, Nurse Midwife, Certified Registered Nurse Anesthetist, Physical Therapist, Occupational Therapist, Speech Therapist, Audiologist, or Behavioral Therapist. NOTE: Behavioral Therapists must submit either BCBA certification or Behavioral Therapy Attestation Form.)
Copy of the license of the Physical, Occupational, or Speech Therapist who is affiliated with the group (397)
Copy of the individual license of the MD, DO, OD or DPM who is affiliated with the group (470)
Copy of the Licensed Psychologist or Physician who is affiliated with the group
Department of Human Services Permanent Child Care License indicating Service Type as Residential Child Care Facility.
Copy of the license of the physician, osteopath, advanced practice nurse or physician assistant who is affiliated with the group.
ENROLLMENT TYPE: Facility
THIS PROVIDER TYPE IS NO LONGER AVAILABLE FOR ENROLLMENTS. Services may be provided under the "Licensed Behavioral Health Clinician" Provider Type.