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02/04/2013 – Provider Enrollment Application Fee

Effective March 1, 2013, Ohio started collecting a non-refundable application fee upon initial application to enroll as a Medicaid provider and also every 5 years at the point of revalidation.  PLEASE NOTE:

 

  • The fee applies to organizational providers only; it does not apply to individual providers and practitioners or practitioner groups.
  • The fee is currently $532 per application and it will increase annually for inflation.  The fee is set by the Centers for Medicare and Medicaid Services (CMS).
  • This fee is an application processing fee and will not be refunded if your application is denied or if it is returned to you as not processed due to being incomplete.
  • Applicants who are enrolled as Medicare providers or in another state as a Medicaid provider, and have paid the associated fees to either program, will not have to pay it again to enroll as an Ohio Medicaid provider.  However, applicants who indicate this must submit proof of payment with their application.
  • There may be further clarification from CMS about the acceptable timeframes to be excused from paying the fee if the provider has already paid to Medicare or another state's Medicaid.  Ohio Medicaid will provide additional information about this as it becomes available.
  • The fee is a federal requirement.  Please see 42 CFR 455.460 Application Fee and/or OAC 5101:3-1-17.8(C) for more information about the fee.
Provider Revalidation Begins in Ohio
The Affordable Care Act (ACA) requires all Medicare and Medicaid providers to revalidate their provider enrollment information at least every five years.  Even before the passage of the ACA, Ohio initiated a similar requirement for nearly all Ohio Medicaid providers (See OAC 5101:3-1-17.4).  The revalidation process has started in Ohio.  The Ohio Department of Medicaid will notify you by mail, when you need to complete a revalidation application. Additional information on revalidation.

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