CMS uses site visits to verify that a provider is operating at the practice location reported to Medicare and that enrollment information is accurate. Site visits help protect the integrity of the Medicare program and may be required for certain provider types as part of Medicare's risk-based screening requirements.

When Site Visits Occur

A site visit may occur during initial Medicare enrollment, revalidation, the addition of a new practice location, or when CMS determines additional verification is needed. Certain provider types are subject to mandatory site visits during the enrollment process. CMS also has the authority to conduct site visits for other enrolled providers when necessary.

Site Visit Process

Site visits are typically unannounced and conducted during normal business hours. A CMS-authorized contractor will visit the practice location to verify information reported on the enrollment application and confirm that the location is operational. During the visit, the inspector may review signage, verify contact information, observe business operations, speak with staff, review certain records, and take photographs of the location. Inspectors carry a photo ID and a CMS authorization letter.

Preparing for a Site Visit

Providers should ensure the information reported to Medicare accurately reflects their practice location and day-to-day operations. Keeping addresses, telephone numbers, business hours, and other enrollment information current can help prevent processing delays and enrollment issues.

Practices should maintain clear signage, ensure phone numbers are active and monitored, and make staff aware that a site visit may occur without advance notice. Staff should know how to identify authorized inspectors and assist with verification requests.

Common Site Visit Findings

Enrollment issues may arise when inspectors are unable to verify that a location is operational or when information at the practice location does not match Medicare enrollment records. Common findings include incorrect addresses, inactive telephone numbers, missing signage, inaccessible locations, or offices that are not open during reported business hours. These issues can delay application processing and may result in administrative action when enrollment requirements cannot be verified.

Maintaining Compliance

Providers are responsible for keeping their Medicare enrollment records current and reporting changes within applicable CMS timeframes. Regularly reviewing enrollment information and promptly reporting changes to practice locations, ownership, contact information, or other enrollment data can help ensure continued compliance and avoid unnecessary delays.