How can I get my billing privileges reactivated?

There are several reasons why billing privileges may become deactived. These include:

  • The supplier failed to complete/return the revalidation package within the established time frame
  • The supplier did not submit claims for four consecutive quarters
  • The supplier did not meet the conditions outlined in the Medicare DMEPOS supplier standards
  • The supplier voluntarily terminated Medicare billing privileges 

If the billing privileges are deactivated for any reason and the billing privileges were not reactivated through the rebuttal process, the CMS 855S must be completed in its entirety. All attachments (e.g., licenses, insurance, IRS documents, copy of the NPI notification) must be included. The CMS 855S may be downloaded from the CMS website or suppliers may submit the application electronically through the Provider Enrollment Chain and Ownership System (PECOS). 

Note: Billing privileges will not be reactivated until the entire process is completed and the supplier has been determined to be in compliance with the supplier standards. It is in the best interest of the supplier to keep on top of revalidation, etc., to make sure that its billing privileges are not deactivated. Claims cannot be paid during the time billing privileges are deactivated.

Last Updated: 09/14/2022