Provider Enrollment Corrective Action Plan (CAP), Reconsideration, and Rebuttal Decision Tree - JF Part A

Are you a Part A Provider?

Are you appealing a deactivation?

Use the Part B Provider Enrollment Appeals Decision Tree.

Rebuttals can only be submitted for the following deactivation reasons:

• Non-response to a revalidation request
• Failure to report a change
• Non-billing
• No active practice location for 90 days
• Not in compliance with all enrollment requirements
• Practice location is non-operational or otherwise invalid
• The provider/supplier is deceased
• The provider/supplier is voluntarily withdrawing from Medicare
• The provider is the seller in a HHA change of ownership under

Were you deactivated for one of these reason?

Are you appealing a rejected or returned application?

Rejected and returned applications do not have appeal rights.

Corrective Action Plans (CAPs) must be received within 35 days of the initial determination letter.

Reconsiderations must be received within 65 days of the initial determination letter.

Submit your appeal to CMS using the CMS Appeal Coversheet.

A rebuttal must be received within 15 days from the date of the deactivation letter.

Is the date on the letter more than 15 calendar days ago?

You do not have rebuttal rights. Contact the Provider Enrollment Contact Center for assistance.

Your rebuttal rights have expired. You may reactivate your Medicare enrollment.

You may submit a rebuttal.