What's Changing in Medicare Provider Enrollment for 2026

The 2026 enrollment application fee

CMS updated the Medicare enrollment application fee for 2026 to $750, per its official guidance (MLN9658742). The fee applies to institutional providers and suppliers such as DMEPOS suppliers and opioid treatment programs when enrolling, re-enrolling, revalidating, or adding a new practice location. Physicians, non-physician practitioners, physician organizations, and MDPP suppliers remain exempt from the application fee. A hardship exception process exists for organizations that qualify.

A proposed rule that would change how revocations work

On July 6, 2026, CMS published a proposed rule as part of the CY2027 Home Health Prospective Payment System rulemaking that would affect Medicare enrollment for all provider and supplier types, not only home health. It is important to be precise about its status: this is a proposed rule, not yet final, with the public comment period running through August 31, 2026.

What the proposal would change

The core change is retroactivity. Today, most revocations take effect 30 days after CMS or its contractor mails a notice to the provider. The proposal would make revocations effective retroactively to the date of the underlying noncompliance for all revocation grounds, which materially increases the financial exposure of a revocation. The proposal also adds new revocation and denial grounds tied to the 36-month rule, geographic concentration of billing, and co-location with previously revoked providers, and it would broaden the definitions of managing employee and affiliation while removing the current five-year lookback limit on affiliation disclosures.

Enrollment moratoria already in effect

Separately from the proposed rule, CMS has used its existing moratorium authority twice in 2026. A temporary nationwide moratorium on initial enrollment applications from DMEPOS medical supply companies took effect February 27, 2026. A second moratorium on initial applications from home health agencies and hospices took effect May 13, 2026. Both moratoria run in six-month increments and can be extended; neither affects revalidations or changes of information for providers already enrolled, only new initial applications and certain changes in majority ownership.

A change to how site visits are verified

CMS transitioned to two new provider enrollment site visit contractors effective January 3, 2026. Site visit inspectors carry a CMS-issued letter of authorization and photo identification, which a practice may review but not retain or copy. Confirming a site visit through your Medicare Administrative Contractor before granting entry remains the correct verification step, since the contractor change does not alter that process.

What this means for a practice managing its own enrollment

None of the moratoria above apply to physician practices billing under standard provider types, so the immediate operational impact for most medical practices is limited. The proposed rule is the item worth watching: if finalized as proposed, a revocation would reach back to the date of noncompliance rather than starting from the notice date, which changes how much is at stake in staying current on enrollment requirements such as revalidation deadlines and accurate ownership and affiliation disclosures. The comment period is still open, and the final rule may differ from what was proposed.