CMS Revalidation Mandate

2026 Provider NPI and Revalidation Requirements

On April 23, 2026 all state Medicaid Directors received a letter mandating states create a provider revalidation (Medicaid provider enrollment) plan and to submit that plan to the Centers for Medicare and Medicaid Services (CMS). This requirement impacts all Medicaid providers, including Home and Community Based Services (HCBS) and State Plan providers.

The Division is initiating targeted revalidations and implementing a mandatory National Provider Identifier (NPI) policy across all provider types. These are two separate, yet related aspects of Wyoming Medicaid compliance with the CMS mandate.

NPI Requirement

All Wyoming Medicaid enrolled providers, regardless of taxonomy, are required to obtain a valid National Provider Identifier (NPI) and report it to Wyoming Medicaid. There are no longer any providers who are exempt from having an NPI. Providers who currently do not hold an NPI will be treated as high-risk until an NPI is on file. All active providers must ensure their NPI is added to their enrollment record on or before October 31, 2026.

Failure to obtain an NPI and process it with the Department will result in a payment suspension on November 1, 2026, and disenrollment on February 1, 2027.

To obtain a National Provider Identifier (NPI), please visit the National Plan and Provider Enumeration System (NPPES) website. For more key information on how to obtain an NPI, important deadlines, and impact of non compliance please see the Medicaid Bulletin issued by the Wyoming Department of Health, or view the resources in the Additional Information drop-down below.

Revalidation Requirement

Revalidation is a standard process that Medicaid enrolled providers complete on a five-year cycle. As part of this CMS mandate, however, some providers may be required to complete a one-time revalidation earlier than their typical five-year cycle. Specific revalidation timelines are dependent on when a provider completed their last revalidation and a provider’s identified risk-level. Providers will receive the standard 90, 60, and 30 day email notices from the Provider Message Center when their revalidation is due so please keep an eye on your inbox. Providers can also log in to my DyP to verify their next required revalidation date.

Failure to complete a timely revalidation will result in disenrollment.

The Division will continue to issue guidance and support materials for HCBS waiver providers to assist in meeting the new requirements.