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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:
- A swift
revalidation for high-risk providers
- A 24-month
revalidation for Moderate and Limited-risk providers
Which provider type is subject to High-risk off-cycle
revalidation?
- Durable
Medical Equipment (DME)/Medical Supply Dealer (including POP providers)
- Home
Health Agency
- Hospice
- Nursing Facility
- Applied
Behavior Analysis (ABA) Therapy
- Behavioral
Health
Which provider type
is subject to Moderate and/or limited risk off-cycle revalidation?
- Ambulatory
Surgical Center (ASC)
- Anesthesiology
Assistant (AA)/Physician Assistant (PA) Physician Employed
- Audiology/Hearing
Service
- Certified
Registered Nurse Anesthetist (CRNA)/Certified Registered Nurse Practitioner (CRNP)/Certified Nurse Midwife (CNM)
- Chiropractor
- CRS
Physician – State Agency
- Dentist
- End-Stage
Renal Dialysis (ESRD) Clinic
- Eye Care
(Optician, Optometrist, Ophthalmologist)
- Federally
Qualified Health Centers (FQHC)
- Hospital
- Independent
Lab
- Independent
Radiology (X-ray Clinic)
- Independent
Rural Health Clinic (IRHC)
- Mental
Health Provider
- Nurse-Family
Partnership (NFP)
- Oral
Surgeon
- Ordering,
Prescribing and Referring (OPR)
- Pharmacy
- Physician
- Podiatrist
- Private
Duty Nursing
- Provider-Based
Rural Health Clinic
- Psychiatric
Hospital (Under 21)
- Psychiatric
Hospital (Beneficiaries 65 and over)
- Psychologist
- Public
Health Agency – State Agency
- Registered
Dietitian/Nutrition Professional
- Remote
Patient Monitoring (RPM)
- Targeted
Case Management (TCM)
- Therapist
(Occupational, Physical and Speech)
- Transportation
(Emergency Air & Ambulance)
- 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:
- Download the Revalidation Facsimile from
the Medicaid Secure Web Portal at https://www.medicaid.alabamaservices.org/alportal/Account/Secure%20Site/tabId/22/Default.aspx.
- Complete the
Revalidation Facsimile and all applicable forms.
- Submit the
Revalidation Facsimile and all forms via the Medicaid Secure Web Portal.
Which forms should a provider submit for
revalidation?
- Provider Agreement
- Individual
Disclosure Form (required for individual providers completing revalidation)
- Facility/Group
Disclosure Form (required for providers who operate as a corporation,
organization, institution, agency, partnership, professional association or
similar entity)
- W-9 Tax
Form (if tax name or service location address changes apply)
- CLIA
Certificate (if applicable changes)
- DEA
Certificate (if applicable changes)
- EPSDT Agreement (required if the provider is or
would like to participate as an EPSDT provider)
- Plan First
Agreement (required if the provider is or would like to render services to Plan
First beneficiaries)
- Certification of Mammography Systems (required
if the provider is or would like to render mammography services)
- 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 © 2026 American Medical Association
and © 2026 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.