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.
Sept. 30, 2014 - Please review the Behavioral Health Multi-Specialty Group (MSG) versus Behavioral Health Services Organization (BHSO).
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.
Important Announcement regarding newly enrolling provider types and other changes for enrollment due to the Medicaid expansion
Nov. 18, 2013 - Below is a list of new provider types that we anticipate enrolling effective Jan. 1, 2014 due to Medicaid expansion under the Affordable Care Act. Please note that the new provider types are subject to change pending CMS approval. In addition, the regulations and enrollment requirements for each provider type are still being developed.
Starting Nov. 18, 2013, providers may submit an enrollment application for these new provider types. Although enrollment requirements are still being determined, each entity/individual must be licensed and submit their NPI documentation as well as SSN or FEIN verification. Applications will be held and processed once CMS approval is received and the regulations and enrollment requirements are finalized. DMS will provide new information as it becomes available.
As with the current enrollment process, if a provider will be contracting with an MCO the provider will need to submit their application through the MCO of their choice.
New Provider Types
- 18 - Private Duty Nursing Agency
- 66 - Behavioral Health Multi-Specialty Group
- 79 - Speech Language Pathologist
- 799 - Speech Language Pathologist Group
- 81 - Licensed Professional Clinical Counselor
- 819 - Licensed Professional Clinical Counselor Group
- 83 - Licensed Marriage and Family Therapist
- 839 - Licensed Marriage and Family Therapist Group
- 84 - Licensed Psychological Practitioner
- 849 - Licensed Psychological Practitioner Group
The QMB limitation will be removed from these QMB Provider Types Revised effective Jan. 1, 2014 subject to CMS approval. If you are currently enrolled in this provider type you will automatically be transitioned:
- 82 - Licensed Clinical Social Worker
- 87 - Physical Therapist
- 879 - Physical Therapist Group
- 88 - Occupational Therapist
- 889 - Occupational Therapist Group
- 89- Licensed Psychologist
- 899 - Licensed Psychologist Group
April 11, 2013 If you are enrolling in KY Medicaid and will be participating with any of the Managed Care Organizations (MCOs), you will need to send your enrollment application to one of the MCOs of your choice.
Do not submit enrollment applications directly to KY Medicaid unless you are NOT participating with any of the MCOs.
- Coventry - 855-300-5528
- Humana Caresource - 800-457- 5683
- KY Spirit - 866-643-3153
- Passport - 800-578-0775
- Wellcare - 877-389-9457
Region 31 Provider Enrollment Notice
Jan. 1, 2013 - Providers if you would like to request participation as a Humana - CareSource Provider, Please call 1-800-457-5683 or email us at ProviderMedicaidEnrollment@Humana.com.
Provider Enrollment Notice
Sept. 12, 2013 - If you are a home medical equipment provider and are required to be licensed by the KY Board of Pharmacy as such, please submit a copy of your license to KY Medicaid. For more information regarding this new requirement (effective Sept. 30, 2012), please visit the KY Board of Pharmacy's website. Please mail a copy of your license to the following address:
PO Box 2110
Frankfort, KY 40602
Please also include your KY Medicaid provider number on the copy of the license.
(Sept. 28, 2011) - When sending any type of correspondence to Kentucky Medicaid provider enrollment, please write your NPI and/or Kentucky Medicaid provider number on each document. If you submit documents for multiple providers submitted in the same envelope, please staple or paperclip each providers own documents separately. Although, we prefer that you do not attach multiple providers' documents in the same envelope.
2010 Enrollment Updates
Notice - Updated Provider Types now required for NPI
Posted: October 2007
The following provider types are now required to obtain an NPI and taxonomy code(s), submit their NPI and taxonomy code(s) to KY Medicaid, and utilize the NPI and taxonomy code(s) when they bill KY Medicaid:
- Preventive and Remedial Public Health (20)
- Adult Targeted Case Management (27)
- Children Targeted Case Management (28)
- Model Waiver (41)
- Home and Community Based Waiver (42)
- Hearing Aid Dealer (50)
- X-Ray/Misc. Supplier (86)
These provider types were previously excluded based on DMS's interpretation of the "Final Rule" but after revisiting this issue, it has been determined that these programs must be included.