Ky.gov

Cabinet for Health and Family Services

Provider Maintenance Information

​Kentucky Medicaid is responsible for maintaining complete files for every provider enrolled. These provider files are maintained and updated regularly by the provider services branch.

Please notify Provider Enrollment of any changes to provider name, address, ownership, etc., by contacting:

Kentucky Medicaid
Provider Enrollment
P.O. Box 2110,
Frankfort, KY 40602

 

​Forms

MAP-347, the Statement for Authorization of Payment,Group Linkages Section form

MAP-529, KY Medicaid Change of Information Form 

Contact Information

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