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42 CFR 455.460 requires certain providers to submit an application fee for initial enrollment and revalidation. Generally, the application fee applies to institutional providers as defined by Centers for Medicare and Medicaid Services (CMS) and not to individual professionals, such as physicians.

Provider types subject to application fee

  • Ambulance Service Supplier (55)
  • Ambulatory Surgical Center (36)
  • Community Mental Health Center (30)
  • Comprehensive Outpatient Rehabilitation Facility (91)
  • Durable Medical Equipment, Prosthetics, Orthotics, and Supplies(90)
  • End-Stage Renal Disease Facility (39)
  • Hospice (44)
  • Hospital (01)
  • Home Health Agency (34)
  • Independent Clinical Laboratory (37)
  • Portable X-Ray Supplier (86)
  • Primary Care Center/Federally Qualified Health Center (31)
  • Rural Health Clinic (35)
  • Skilled Nursing Facility (12)

CMS sets the application fee amount, which may be adjusted annually. The application fee for 2020 is $595. If you are subject to the fee at initial enrollment or revalidation submit the payment using the Kentucky Medicaid Partner Portal Application (MPPA).

Providers having paid an application fee to Medicare or to another state Medicaid agency will not be required to make payment. Kentucky Medicaid Provider Enrollment verifies the payment and required matching information (provider type/risk category, practice location/address, FEIN, five-percent owners) during the enrollment and revalidation processes.

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