To become a Medicaid provider, you need to first get a license from the state. Then, you can sign up with Medicaid and begin receiving payments for your services.
You can find out more about becoming a Medicaid provider by contacting your state’s Department of Health, where they will be able to give you more information about the process.
How To Become Medicaid Provider
Ready to become a Medicare provider or supplier? This guide will help you enroll in three steps.
Do not use this guide if…
- You’re a DMEPOS supplier. DMEPOS suppliers should follow the instructions on the Enroll as a DMEPOS Supplier page.
- You’re an institutional provider. If you’re enrolling a hospital, critical care facility, skilled nursing facility, home health agency, hospice, or other similar institution, you should use the Medicare Enrollment Guide for Institutional Providers.
MEDICARE ENROLLMENT GUIDE
FOR PROVIDERS & SUPPLIERS
Use this guide if any of the following apply:
- You’re a health care provider who wants to bill Medicare for your services and also have the ability to order and certify.
- You don’t want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify.
- You wish to provide services to beneficiaries but do not want to bill Medicare for your services. (In this case, you would need to opt out of Medicare.)
- You want to enroll as a supplier who does not dispense or furnish durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). (You can still use this guide if you dispense Part B drugs used with DMEPOS, such as inhalation drugs.)
| 1 | Step 1: Get an NPIIf you already have an NPI, skip this step and proceed to Step 2.NPIs are issued through the National Plan & Provider Enumeration System (NPPES). You can apply for an NPI on the NPPES website. Not sure if you have an NPI? Search the NPI Registry. |
| 2 | Step 2: Complete the Medicare Enrollment ApplicationEnroll using PECOS,i the online Medicare enrollment system. PECOS has video and print tutorials and will walk you through your enrollment to ensure your information is accurate. Complete the online PECOS application. |
| 3 | Step 3: Work with Your MACYour Medicare Administrative Contractor (MAC) is specific to the region where you practice and may have additional requests for information while they process your application. You can also check in with your MAC regarding your enrollment status. Contact Your MAC (PDF). |
Keep Your Information Current
It’s important to keep your enrollment information up to date. To avoid having your Medicare billing privileges revoked, be sure to report the following changes within 30 days:
- a change in ownership
- an adverse legal action
- a change in practice location
You must report all other changes within 90 days. If you applied online, you can keep your information up to date in PECOS. If you applied using a paper application, you’ll need to resubmit your form to update information.
