Provider Enrollment

Welcome to the Kentucky Medicaid provider enrollment website

Thank you for choosing to participate in the Kentucky Medicaid Program. The Kentucky Medicaid Program appreciates your interest and welcomes the opportunity to work with you to provide health care services to Kentucky Medicaid members.

• If you want to learn about KY Medicaid Provider, refer to What is a KY Medicaid Provider?
• If you are a new provider, refer to the Application Information and Provider Type Summaries.
• If you are an existing provider and need to make changes, refer to Maintenance Information.
• If you need to update your License, refer to Update Your License Information with KY Medicaid
• If you would like to read Provider Enrollment updates click here. *New Information*

If you have any further questions or need assistance, please either email us at Program.Integrity@ky.gov or call toll free: (877) 838-5085 Monday to Friday 8 a.m. - 4:30 p.m. ET.

Note: Please read the Important Provider Enrollment Information regarding new phone hours and email address.

Attention Providers

(04/11/13) If you are enrolling in KY Medicaid and will be participating with any of the MCO's (Managed Care Organizations), you will need to send your enrollment application to one of the MCO's of your choice.

Do not submit enrollment applications directly to KY Medicaid unless you are NOT participating with any of the MCO's.

• 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

(01/01/13) - 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

(09/12/12) - 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 9/30/2012), please visit the KY Board of Pharmacy's website. Please mail a copy of your license to the following address:

KY Medicaid
PO Box 2110
Frankfort, KY 40602

Please also include your KY Medicaid provider number on the copy of the license.

September 2011

(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.

June 2011

• Update for KY non-Medicaid Prescribing Providers as of June 2011
• MAP Form Update effective June 1, 2011

March 2011

• Final Rule indicates that certain providers will be required to pay an application fee effective March 25, 2011.

2010 Enrollment Updates

• Update for KY non-Medicaid Prescribing Providers as of September 2010
• DHS/INS Authorization Information effective August 15, 2010
• Social Security Verification Notice effective July 15, 2010

On Jan. 16, the Centers for Medicare and Medicaid Services issued a letter to state Medicaid directors reiterating a long-standing policy. The letter clarifies the federal statutory and regulatory prohibitions regarding providers who have been excluded from participation in Federal Health Care programs. For more information please review the following letters.

• KY Medicaid General provider Letter regarding excluding providers
• CMS Letter regarding excluding Providers

You may also visit the Office of the Inspector General Exclusions Program website for the List of Excluded Individuals/Entities.

Updated Kentucky Medicaid Excluded/Termed Provider Listing

• Alphabetical Listing: PDF and Excel
• Date: PDF and Excel