All High-Risk Providers

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TO: All High-Risk Providers

RE: Alabama Medicaid 2026 Off-Cycle Revalidation

In response to a request from the Centers for Medicare and Medicaid Services (CMS), the Alabama Medicaid Agency (Medicaid) will conduct two types of off-cycle revalidations:

1. A swift revalidation for high-risk providers

2. A 24-month revalidation for Moderate and Limited-risk providers

Which provider type is subject to High-risk off-cycle revalidation?

1. Durable Medical Equipment (DME)/Medical Supply Dealer (including POP providers)

2. Home Health Agency

3. Hospice

4. Nursing Facility

5. Applied Behavior Analysis (ABA) Therapy

6. Behavioral Health

Which provider type is subject to Moderate and/or limited risk off-cycle revalidation?

1. Ambulatory Surgical Center (ASC)

2. Anesthesiology Assistant (AA)/Physician Assistant (PA) Physician Employed

3. Audiology/Hearing Service

4. Certified Registered Nurse Anesthetist (CRNA)/Certified Registered Nurse Practitioner (CRNP)/Certified Nurse Midwife (CNM)

5. Chiropractor

6. CRS Physician - State Agency

7. Dentist

8. End-Stage Renal Dialysis (ESRD) Clinic

9. Eye Care (Optician, Optometrist, Ophthalmologist)

10. Federally Qualified Health Centers (FQHC)

11. Hospital

12. Independent Lab

13. Independent Radiology (X-ray Clinic)

14. Independent Rural Health Clinic (IRHC)

15. Mental Health Provider

16. Nurse-Family Partnership (NFP)

17. Oral Surgeon

18. Ordering, Prescribing and Referring (OPR)

19. Pharmacy

20. Physician

21. Podiatrist

22. Private Duty Nursing

23. Provider-Based Rural Health Clinic

24. Psychiatric Hospital (Under 21)

25. Psychiatric Hospital (Beneficiaries 65 and over)

26. Psychologist

27. Public Health Agency - State Agency

28. Registered Dietitian/Nutrition Professional

29. Remote Patient Monitoring (RPM)

30. Targeted Case Management (TCM)

31. Therapist (Occupational, Physical and Speech)

32. Transportation (Emergency Air & Ambulance)

33. Waiver Provider - State Agency

Some off-cycle revalidations may be exempted from this project. Once those exemptions are determined, Medicaid will post any exempted provider categories on its website.

How will a provider know when to complete the off-cycle revalidation?

If you must complete the off-cycle revalidation, Medicaid will issue revalidation notices to providers in phases.

Important: Providers must respond timely as the revalidation notice specifies. Failure to complete revalidation timely could affect a provider's enrollment with Medicaid.

What steps are necessary to complete revalidation?

Upon receiving a Revalidation Notice, a provider must:

1. Download the Revalidation Facsimile from the Medicaid Secure Web Portal at https://www.medicaid.alabamaservices.org/alportal/Account/Secure%20Site/tabId/22/Default.aspx.

2. Complete the Revalidation Facsimile and all applicable forms.

3. Submit the Revalidation Facsimile and all forms via the Medicaid Secure Web Portal.

Which forms should a provider submit for revalidation?

1. Provider Agreement

2. Individual Disclosure Form (required for individual providers completing revalidation)

3. Facility/Group Disclosure Form (required for providers who operate as a corporation, organization, institution, agency, partnership, professional association or similar entity)

4. W-9 Tax Form (if tax name or service location address changes apply)

5. CLIA Certificate (if applicable changes)

6. DEA Certificate (if applicable changes)

7. EPSDT Agreement (required if the provider is or would like to participate as an EPSDT provider)

8. Plan First Agreement (required if the provider is or would like to render services to Plan First beneficiaries)

9. Certification of Mammography Systems (required if the provider is or would like to render mammography services)

10. Corporate Board of Directors Resolution (required for physician groups that operate as a corporation)

Some revalidation resources available for a provider include:

For questions regarding or assistance with revalidation, please contact Provider Enrollment at (888)223-3630.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 20 26 American Medical Association
and © 20 26 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.