# Pennsylvania Medicaid Enrollment: Active ID, Paid Claims > Pennsylvania Medicaid enrollment in 2026: the December 31, 2026 revalidation deadline for high risk providers and 5 year revalidation by location. Source: https://webillhealth.com/pennsylvania-medicaid-provider-enrollment/ Publisher: WeBill Health Last updated: November 4, 2026 Pennsylvania Medicaid ## Pennsylvania Medicaid, revalidated and paid An active Pennsylvania Medicaid ID, every service location revalidated on time, and no closed locations. [Request a Revenue Defense Audit](https://webillhealth.com/revenue-defense-audit/request/) Pennsylvania Medicaid enrollment is tracked service location by service location, and each location has its own revalidation date. The Department of Human Services lists the steps on its [Enroll as a Medicaid Provider page](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider). * Revalidation cycle All providers must revalidate the Medical Assistance enrollment of each service location every 5 years. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) * When to submit Providers should submit revalidation applications at least 60 days prior to the revalidation dates. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) * High risk deadline Providers categorized as high risk who revalidated before July 1, 2025, and select others, must revalidate again no later than December 31, 2026 to remain enrolled. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) * Missed deadline A high risk service location is closed if revalidation is not completed by the due date on its notices. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) * What we see in practice 45 to 90 days from submission to an active Medicaid ID. ## In the official words > To be eligible for enrollment as a Medicaid provider, practitioners in Pennsylvania must be licensed and currently registered by the appropriate state agency. [Pennsylvania Department of Human Services](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) > High-risk providers must submit a revalidation application by the due date indicated on their 90-day and 30-day revalidation notices. [Pennsylvania Department of Human Services](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) ## High risk providers must revalidate again by December 31, 2026 A Medical Assistance Bulletin issued August 21, 2026 on off cycle revalidation of high risk providers sets a second deadline for two groups: high risk providers who revalidated before July 1, 2025, and select high risk providers who revalidated on or after that date. Both must revalidate again by December 31, 2026 to stay enrolled. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) CMS asked the department for a swift revalidation of high risk providers and a two year revalidation strategy. The department submitted its plan on June 5, 2026, and the plan requires revalidation of all high risk providers and provider types enrolled in the program by December 31, 2026. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) A provider is high risk when it meets one of several criteria. They include a payment suspension based on a credible allegation of fraud, waste or abuse, exclusion from Medicare or another state’s Medicaid or CHIP program by the U.S. Department of Health and Human Services Office of Inspector General within the last ten years, and an outstanding overpayment greater than $1,500 that is more than 30 days old, is not being appealed and is not on an approved repayment schedule. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) Affected providers receive individual communication at the email address on their provider file. They must submit the revalidation application by the due date on their 90 day and 30 day notices. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) The next revalidation date for these providers is December 2028, and they then shift to a five year revalidation cycle. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) ## How enrollment works, step by step 1. Confirm eligibility. Practitioners in Pennsylvania must be licensed and currently registered by the appropriate state agency. Other providers must be approved, licensed, issued a permit or certified by the appropriate state agency and, if applicable, certified under Medicare. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) 2. Get the application for your provider type from the [Provider Enrollment Documents page](https://www.pa.gov/agencies/dhs/resources/for-providers/provider-enrollment-information/provider-enrollment-documents), which holds enrollment and revalidation applications and requirements for each provider type. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) 3. If the provider is high risk, complete the criminal background checks, and have anyone with a five percent or greater direct or indirect ownership interest do the same. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) 4. Ask each managed care organization about its network separately. Enrollment in the Medicaid program does not guarantee enrollment in individual managed care organization networks, and new providers should contact each organization directly. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) In Pennsylvania the time follows the application for your provider type and the locations it covers. Each service location has its own revalidation date, and a high risk provider, or anyone with a five percent or greater ownership interest in one, adds criminal background checks. More locations and more screening mean more to finish. Our planning figure is 45 to 90 days from submission to an active Medicaid ID. ## Risk screening and routine revalidation The department has assigned certain provider types and specialties to the high categorical risk level. The Affordable Care Act requires providers deemed high risk to obtain criminal background checks, and any person with a five percent or greater direct or indirect ownership interest in a high risk provider must also submit criminal background check information. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) Treat each service location as its own calendar item. Log into [PROMISe](https://promise.dhs.pa.gov/portal/provider/Home/tabid/135/Default.aspx) to check the revalidation date of each location, and file the application at least 60 days ahead of it, since the routine cycle is 5 years per location. The electronic revalidation application is available from the My Home page after logging in. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) [Pennsylvania DHS, Provider Enrollment FAQ](https://www.pa.gov/agencies/dhs/resources/for-providers/provider-enrollment-information/faqs-provider-enrollment) Keep contact information on the provider file current. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) ## Where Pennsylvania enrollments lose money Check the due date on both notices, because a missed date closes the location in [PROMISe](https://promise.dhs.pa.gov/portal/provider/Home/tabid/135/Default.aspx), and that closure is the consequence the bulletin names. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) An unpaid debt can put a provider in the off cycle group. A provider with an outstanding overpayment greater than $1,500 that is more than 30 days old stays categorized as high risk until the overpayment is repaid. [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) State enrollment does not mean network participation. Enrollment in the Medicaid program does not guarantee enrollment in individual managed care organization networks. [Pennsylvania DHS, Enroll as a Medicaid Provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) ## Check where you stand before you submit WeBill Health runs Revenue Velocity Credentialing with 24/7 CAQH and PECOS lifecycle monitoring, so revalidation dates and affiliation gaps are caught before they become suspended claims. Every file gets Human Expert Review from a credentialing specialist before it goes to the state. ## Sources * [Pennsylvania DHS, Medical Assistance Bulletin, August 21, 2026](https://www.pa.gov/content/dam/copapwp-pagov/en/dhs/documents/docs/publications/documents/forms-and-pubs-omap/mab2026082101.pdf) * [pa.gov, enroll as a medicaid provider](https://www.pa.gov/services/dhs/enroll-as-a-medicaid-provider) * [pa.gov, faqs provider enrollment](https://www.pa.gov/agencies/dhs/resources/for-providers/provider-enrollment-information/faqs-provider-enrollment) ## Revenue Velocity Credentialing WeBill Health manages the full payer enrollment lifecycle, so your revenue cycle starts the moment your practice does. **Up to 40%** less payer enrollment lag against the industry baseline **24/7** CAQH and PECOS lifecycle monitoring [See Revenue Velocity Credentialing](https://webillhealth.com/revenue-velocity-credentialing/) ## More state enrollment guides Each neighboring state issues its own Medicaid ID under its own rules and timelines. * [Delaware](https://webillhealth.com/delaware-medicaid-provider-enrollment/) * [Maryland](https://webillhealth.com/maryland-medicaid-provider-enrollment/) * [New Jersey](https://webillhealth.com/new-jersey-medicaid-provider-enrollment/) See every state on [Medicaid provider enrollment by state](https://webillhealth.com/medicaid-provider-enrollment/). If providers are already seeing patients before their ID is active, read [The Credentialing Gap](https://webillhealth.com/credentialing-gap/). Reviewed by [James Whitaker](https://webillhealth.com/james-whitaker/), Credentialing Lead, on November 4, 2026. Facts verified November 1, 2026. ## Review your enrollment status with us The Revenue Defense Audit is a free, forensic review of your claims and A/R by the team that would work your account, including providers seeing patients under a payer that cannot pay them yet. Want a quick read first? [Check my Revenue Defense Score](https://webillhealth.com/revenue-defense-score/) for the credentialing and denial exposure in your specialty. [Request a Revenue Defense Audit](https://webillhealth.com/revenue-defense-audit/request/) WeBill Health is a specialty focused revenue cycle management partner for independent practices. Request a Revenue Defense Audit at https://webillhealth.com/form/