# Medicare Revalidation and Recredentialing: How to Stay in Network in 2027

- URL: https://practicevendors.com/guides/medicare-revalidation-recredentialing-2027/
- By: PV Editorial Team
- Updated: 2026-10-23

> Medicare revalidates every 5 years, Medicaid at least every 5, and most commercial plans recredential every 3. How each cycle works, what happens if you miss one, and how to plan 2027.

## Key Takeaways

- Medicare revalidation is due every 5 years for most providers and every 3 years for DMEPOS suppliers (42 CFR 424.515).
- Medicaid revalidation is required at least every 5 years (42 CFR 455.414), and most commercial plans recredential every 3 years.
- A missed Medicare revalidation can deactivate billing privileges, and claims for that period may not be paid.
- Keep a calendar of every provider's due dates and a CAQH ProView profile that is always current.

A provider who was enrolled and credentialed correctly can still stop getting paid if a revalidation or recredentialing deadline is missed. Medicare, Medicaid and commercial plans each re-check providers on their own schedule, and the reminders are easy to lose. This guide explains each cycle, what happens if you miss one, and how to plan 2027 so no provider in your practice falls out of network.

## The Three Renewal Cycles

| Who | How often | Where it is done |
| --- | --- | --- |
| Medicare revalidation | Every 5 years for most providers and groups; every 3 years for DMEPOS suppliers (42 CFR 424.515) | PECOS, the Medicare enrollment system, or a paper application |
| Medicaid revalidation | At least every 5 years (42 CFR 455.414) | Your state Medicaid agency's enrollment portal |
| Commercial recredentialing | Usually every 3 years, the cycle most plans follow under accreditation standards such as NCQA's | Each plan, usually using your CAQH ProView profile |

## How Medicare Revalidation Works

- CMS publishes revalidation due dates in its Medicare Revalidation List, searchable by name or NPI. Due dates are set about 7 months ahead.
- Your Medicare Administrative Contractor (MAC) sends a notice, usually by email or letter, a few months before the due date. Do not wait for it; it can go to an old address.
- Groups and their individual providers each have their own due dates. Check every provider, not just the group.
- Submit the revalidation in PECOS, together with any reassignment of benefits to your group, and keep the confirmation.

## Keep CAQH ProView Current All Year

Commercial recredentialing depends on the same CAQH ProView profile used for initial credentialing. If the 120-day attestation lapses or a license or malpractice certificate expires in the profile, a plan's recredentialing can stall and the provider can be dropped. Our [CAQH ProView guide](https://practicevendors.com/guides/caqh-proview/) explains how to keep it current.

## Build a 2027 Calendar

- List every provider and the group, with their NPIs.
- Look up each Medicare revalidation due date in the CMS list, and each state Medicaid due date.
- Add each commercial plan's recredentialing date, usually 3 years from the last approval.
- Add license, DEA and board certification expiration dates, and the CAQH attestation date for each provider.
- Set a reminder 90 days before each date, and give one person ownership.

## What to Ask a Credentialing Company

- Do you track revalidation and recredentialing dates for every provider, or only new enrollments?
- Will you warn us at least 90 days before each due date?
- Do you manage CAQH attestations and document uploads between credentialing cycles?
- Will you send us confirmation of each submission and approval?

Compare [credentialing companies](https://practicevendors.com/credentialing-services/) on PracticeVendors, or read [how long credentialing takes](https://practicevendors.com/guides/how-long-does-credentialing-take/) when a new provider joins.

## Common Questions

### How often must Medicare providers revalidate?

Every 5 years for most providers and groups, and every 3 years for DMEPOS suppliers. CMS can also ask for revalidation at other times.

### How do I find my Medicare revalidation due date?

Search the CMS Medicare Revalidation List by name or NPI. Due dates are usually posted about 7 months ahead.

### What happens if I miss a Medicare revalidation?

Your billing privileges can be deactivated. Claims for services during the deactivation may not be paid, and reactivating needs a new, complete application.

### How often do commercial plans recredential providers?

Most recredential every 3 years, the cycle set by accreditation standards such as NCQA's. Each plan sets its own date, so track each one.

## Sources

- [42 CFR 424.515, requirements for reporting changes and revalidation (eCFR)](https://www.ecfr.gov/current/title-42/section-424.515)
- [42 CFR 424.540, deactivation of Medicare billing privileges (eCFR)](https://www.ecfr.gov/current/title-42/section-424.540)
- [42 CFR 455.414, revalidation of Medicaid enrollment (eCFR)](https://www.ecfr.gov/current/title-42/section-455.414)
- [Medicare revalidation (CMS)](https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/revalidations)

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General information from PracticeVendors, not legal or coding advice.