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Provider Enrollment

Welcome to the Kentucky Medicaid provider enrollment website

Thank you for participating in the Kentucky Medicaid Program. The Kentucky Medicaid Program appreciates your interest and welcomes the opportunity to work with you to provide health care services to Kentucky Medicaid members.

If you have any further questions or need assistance, please either email us or call toll free: 877-838-5085 Monday to Friday 8 a.m. - 4:30 p.m. ET.

Note: Please read the Important Provider Enrollment Information regarding new phone hours and email address.

Provider Enrollment Updates

Attention Providers

(May 28, 2015) - Starting July 1st providers will no longer be required to file an Annual Disclosure of Ownership (ADO). Therefore, any provider who has a due date of July 1st and thereafter is not required to submit an ADO. Only those providers with a due date up to and including June 30 are required to submit an ADO.

Medicaid was updating its system to prevent the 60-day and 30-day notice letters from going out to providers with a due date starting July 1, but it did not take effect in time. Therefore, providers may receive letters erroneously.

If a provider has a due date of July 1 and thereafter, please disregard any letters requiring the ADO. However, please do not ignore other correspondence from us including revalidation notices.

Attention Providers - MAP 811 form launch delayed

(May 5, 2015) - An April 26, 2015, letter sent to providers regarding 2015 legislative changes to provider enrollment included the statement, "In addition, effective May 1, 2015, all applications must be submitted on the revised MAP-811 in order to be processed. Otherwise, the application will be returned."

Due to technical difficulties launching the new MAP-811 form, DMS advises providers this change will not take effect until July 1, 2015. You may submit either version of the MAP 811 application until July 1, 2015.

Attention Providers - Important 2015 General Assembly Legislative Changes to the Provider Enrollment Program.

(April 21, 2015) - Thank you for participating as a provider in the Medical Assistance Program. The Department for Medicaid Services is working continuously to improve provider participation and streamline processes and is pleased to inform you of two important changes to KY Medicaid enrollment requirements resulting from legislation passed during the 2015 General Assembly. Read the general provider letter regarding 2015 legislative changes to provider enrollment

Attention Providers - Disabling the Electronic Funds Transfer

Feb. 18, 2015 - The Electronic Funds Transfer (EFT) update function via KY Health Net will be disabled on March 6, 2015. In order to update your EFT, please contact provider enrollment at 877-838-5085 for further instructions. We apologize for any inconvenience.

Attention Providers - Disabling the EADO Process

Jan. 23, 2015 - The Electronic Annual Disclosure of Ownership (EADO) process has been disabled. This functionality may be available in the future. If you have an EADO currently in process, you may be contacted for further information if additional information is needed to process your EADO. We apologize for any inconvenience.

New Provider Types

Nov. 6, 2014 - Effective Dec. 1, 2014, licensed professional art therapist and applied behavior analyst applications will be accepted. However, these two new provider types will not be allowed to enroll until Jan. 1, 2015. The enrollment requirements can be found below.

62   - Licensed Professional Art Therapist

629 - Licensed Professional Art Therapist Group

63   - Applied Behavior Analyst

639 - Applied Behavior Analyst Group

Important KYHealthNet Announcement

Oct. 30, 2014 - Providers who are already enrolled in KY Medicaid are now able to access their provider enrollment file online through KYHealthNet.

If you already have access to KYHealthNet, you are now able to view your contract dates, licensure information, physical, correspondence and pay to address, phone number, fax number, taxonomy, NPI, group practice provider is affiliated with, providers that participate in group practice, annual disclosure of ownership (ADO), and revalidation dates. Once you log on to KYHealthNet, select the Provider Status tab to access your file.

If you do not have access to KYHealthNet, please visit our Healthnet page for instructions on how to sign up for this feature. If you have questions, please contact the EDI Department at HP by email or by phone at 800-205-4696.

Important Announcement

Sept. 30, 2014 - Please review the Behavioral Health Multi-Specialty Group (MSG) versus Behavioral Health Services Organization (BHSO).

Important Announcement

Aug. 26, 2014 - Provider participation in the Kentucky Medicaid Program is through the Provider Licensing and Certification Branch, Division of Program Integrity, Department for Medicaid Services, Cabinet for Health and Family Services. Requirements for enrollment and continued participation (maintenance) are governed by federal and state laws and regulations including, but not limited, to 42 CFR 455 and 907 KAR 1:671 and 907 KAR 1:672. Review the provider enrollment process.

Once enrolled, a provider is required to file an annual disclosure of ownership; is subject to revalidation every five years; must keep his or her license up to date; and notify Medicaid immediately of any changes in information on file.

Electronic Annual Disclosure of Ownership Update

Jan. 22, 2014 - The Electronic Annual Disclosure of Ownership (EADO) process has been temporarily disabled for system maintenance. If you have an EADO currently in process, you may be contacted for further information if additional information is need to process your EADO.

Excluded Providers

On Jan. 16, the Centers for Medicare and Medicaid Services issued a letter to state Medicaid directors reiterating a long-standing policy. The letter clarifies the federal statutory and regulatory prohibitions regarding providers who have been excluded from participation in federal health care programs. For more information please review the following letters.

You may also visit the Office of the Inspector General Exclusions Program website for the List of Excluded Individuals/Entities.

Updated Kentucky Medicaid Excluded/Termed Provider Listing


Regulations, Publications, Termed Provider List

Contact Information

Kentucky Department for Medicaid Services
Provider Enrollment
P.O. Box 2110
Frankfort, KY 40602
Toll free: (877) 838-5085 Monday to Friday
8 a.m. - 4:30 p.m. ET


For other questions or assistance, e-mail the CHFS DMS Webmaster

For question on billing, contact HP at (800) 807-1232 or visit its website.


Last Updated 6/30/2015
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