​​​​​​​​​​​To comply with the Affordable Care Act (ACA) requirements per 42 CFR 455 Subpart E, Kentucky Medicaid must revalidate all providers. The ACA screening criteria apply during revalidation. Providers should not take any steps to revalidate before receiving a notification letter.

Process

Providers receive notification letters with instructions for revalidating 60 and 30 days before their revalidation deadline. Providers should not take any steps to revalidate until they receive a notification letter. Providers who fail to submit revalidation paperwork in a timely manner may have their participation in the Kentucky Medicaid Program suspended.

Providers are required to be revalidated at intervals not to exceed every five years. Providers will be notified when it is time to revalidate their Kentucky Medicaid provider information.

Revalidations are completed using the Kentucky Medicaid Partner Portal Application (KY MPPA). In KY MPPA, a provider can view the current information the Department for Medicaid Services has on file and make updates as needed. ​

Requirements for Revalidation

1. License​​​
2. Registered and Valid National Provider Identifier (NPI) / Taxonomy codes
3. Active Medicare Participation
   
4. All applicable documents for the specific provider type must be submitted or updated using KY MPPA. Please refer to the provider type summary​ for document lists. 
   
5. Social Security Card (required for individual providers revalidating). If the applicant has a Social Security card stating valid for work only, please provide Department of Homeland Security / Immigration and Naturalization Services (DHS  /INS) Authorization. Social Security cards marked not valid for employment will not be accepted.
6. Internal Revenue Service (IRS) Verification of Federal Employer Identification Number (FEIN). If the applicant is the sole owner of a tax ID, please submit the IRS letter of verification of FEIN or official IRS documentation stating the FEIN. The FEIN must be pre-printed by the IRS on documentation. A Form W-9 will not be accepted.
   
7. Application fee, if applicable to the provider type or submit proof of payment from Medicare or another state Medicaid agency.​

Application Fee

Per 42 CFR 455.460, certain providers are subject to 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 this fee:

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

CMS sets the application fee amount, which may be adjusted annually. The application fee for 2026 is $750. Please submit a check payable to Kentucky State Treasurer along with the revalidation packet.

Providers having paid an application fee to Medicare or to another state agency will not be required to make payment. KY Medicaid Provider Enrollment verifies proof of payment during the enrollment and revalidation process.

Risk Levels

Providers are categorized by limited, moderate or high risk level. This determination is made by CMS, based on an assessment of potential for fraud, waste and abuse for each provider type.

Providers enrolling, revalidating or changing ownership will be screened according to their assigned risk level.

General screening activities required for each risk category: