# Virginia Medicaid Enrollment: Active ID, Paid Claims

> Virginia Medicaid enrollment in 2026: the end of the license grace period, matching provider type and specialty to claims, and five year revalidation.

Source: https://webillhealth.com/virginia-medicaid-provider-enrollment/  
Publisher: WeBill Health  
Last updated: November 4, 2026

Virginia Medicaid

## Virginia Medicaid, a matching record and paid

An active Virginia Medicaid ID, a record that matches what you bill, and revalidation done before the due date.

[Request a Revenue Defense Audit](https://webillhealth.com/revenue-defense-audit/request/)

Virginia Medicaid enrollment pays off when the enrollment record stays current and matches what you bill, because DMAS and the managed care plans are prohibited from paying claims to network providers who are not enrolled in the correct provider type and specialty. Start on the [DMAS Provider Enrollment and Revalidation page](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/).

* Revalidation cycle
Medicaid fee for service and managed care network providers need to revalidate enrollment at least every five years, and DMAS notice should arrive at least 90 days before the enrollment period ends. [DMAS, Provider Enrollment and Revalidation](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)
* Missed deadline
Providers who do not revalidate by the due date have their Virginia Medicaid participation terminated from fee for service and managed care networks. [DMAS, Provider Enrollment and Revalidation](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)
* License lapse
DMAS ended its 90 day grace period after license expiration beginning July 1, 2025. [DMAS, Updated Provider Enrollment Requirements](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
* Who can be paid
DMAS and the managed care plans are prohibited from paying claims to network providers who are not enrolled in the correct provider type and specialty for the services billed. [DMAS, Updated Provider Enrollment Requirements](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
* What we see in practice
45 to 90 days from submission to an active Medicaid ID.

## In the official words

> Providers who do not revalidate by the revalidation due date will have their Virginia Medicaid participation status terminated from fee-for-service and MCO networks

[Virginia Department of Medical Assistance Services](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)

> Providers should receive a DMAS notice to begin their revalidation applications at least 90 days before the end of their enrollment period.

[Virginia Department of Medical Assistance Services](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)

## The 90 day license grace period ended July 1, 2025

Historically, DMAS allowed a 90 day grace period following license expiration. Beginning July 1, 2025, that grace period no longer applies. All new or returning providers are now enrolled based on the month they apply or request reinstatement after any lapse in enrollment. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)

DMAS sends courtesy notices 90, 60 and 30 days before license expiration to help support continuous enrollment. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)

## How enrollment works, step by step

1. Start on the [DMAS Provider Enrollment and Revalidation page](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/), which points to the Provider Enrollment home page for new enrollments and revalidations. [DMAS](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)
2. Make sure enrollment is current and active for every service location and provider type. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
3. Match what you bill to what you enrolled. The services provided and billed must align with the enrolled provider type and specialty, and services must be billed as rendered, under the rendering provider’s NPI. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
4. Check periodically that enrollment, contact information and license information are up to date for every service location. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
5. For help with an enrollment or revalidation question, DMAS lists Gainwell as the contact. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)

In Virginia the dates come from the license and the record. Since July 1, 2025 a provider returning after a lapse is enrolled from the month it applies or requests reinstatement, so every week the file waits is a week without coverage. The enrolled provider type and specialty also have to match what you bill, and a correction there adds a round of review. Counting those rounds, we put a Virginia file at 45 to 90 days from submission to an active Medicaid ID.

## Risk screening and the five year revalidation

DMAS screens all providers under federally mandated requirements before approving or renewing participation. It also performs monthly screening of all participating providers, plus a further screening at the time of revalidation. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/22124)

Providers in the fee for service and managed care networks must revalidate at least every five years. DMAS says to expect a notice at least 90 days before the enrollment period ends, sent by email or U.S. Mail, and to begin the application on receipt to allow sufficient time for processing. A revalidation application has to be submitted before the end of the enrollment period, without a gap. [DMAS](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)

## Where Virginia enrollments lose money

The costliest loss is a missed revalidation. Providers who do not revalidate by the due date have their Virginia Medicaid participation terminated from fee for service and managed care networks until they successfully enroll or revalidate. [DMAS](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)

The second is a mismatch between the enrollment record and the claim. DMAS and the managed care plans are prohibited from paying claims to network providers who are not enrolled in the correct provider type and specialty for the services billed. [DMAS](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)

## 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

* [DMAS, Provider Enrollment and Revalidation](https://dmas.virginia.gov/for-providers/provider-enrollment-revalidation/)
* [DMAS, Updated Provider Enrollment Requirements](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/21843)
* [vamedicaid.dmas.virginia.gov, 22124](https://vamedicaid.dmas.virginia.gov/vamed/download-pdf-bulletin/22124)

## 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.

* [Kentucky](https://webillhealth.com/kentucky-medicaid-provider-enrollment/)
* [Maryland](https://webillhealth.com/maryland-medicaid-provider-enrollment/)
* [North Carolina](https://webillhealth.com/north-carolina-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/
