Insurance
Medicare Immediate Recoupment: What is Immediate Recoupment?
In the context of the Medicare claims system, “immediate recoupment” is a process that allows Medicare to automatically recoup money from a provider when Medicare has determined that a claim or claims were improperly paid and there has been an “overpayment.”
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Medicaid
Beginning April 9, 2026, providers are eligible for an additional revalidation due date extension of 60 calendar days if they meet the following criteria:
- The provider’s current revalidation due date is on or before May 31, 2026.
- The provider has an in-flight revalidation application.
Important: Providers should begin the revalidation process as early as 180 days before their revalidation due date to allow sufficient time to complete the process and maintain their enrollment status.
Note: “In-flight” revalidation application refers to an application that the provider has completed in full and submitted through PEMS but has not yet been approved. This does not include applications that are in “Draft” status.
Provider Revalidation Resource Guide
Revalidation One-Pager
PEMS Revalidation and Reenrollment Resources
Providers may refer to the PEMS educational videos on TMHP’s Provider Enrollment & Management System playlist on YouTube, which includes the following:
- Revalidating an Individual
- Revalidating a Performing Provider
- Revalidating a Clinic/Group Practice or Facility
The following resources provide more information about Medicaid provider revalidation requirements and common deficiencies to avoid:
- Common Deficiencies Identified by the Office of Inspector General (OIG)
- Affordable Care Act (ACA) Screening Requirements
For more information about the first revalidation extensions and retroactive enrollment period gap closures, refer to the article titled “Revalidation Due Dates and Retroactive Enrollment Period Gap Closures Extended” that was posted on December 12, 2025.
Providers can access the Provider Enrollment Help page or the PEMS Instructional Site on tmhp.com for additional revalidation or reenrollment support.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.
