Paper forms no longer are accepted. Electronic submission through the
Kentucky Medicaid Partner Portal Application (KY MPPA) is required for all applications, revalidation and maintenance items.
CLIA Changes in Partner Portal
Effective Dec. 21 the following changes will be implemented regarding CLIA information:
New Section 1.15: Your CLIA number, address location NPI and Comments must be added and maintained in this new section.
Section 1.6: Additional Identifiers will no longer contain CLIA information.
Section 1.7: A physical address must be listed for each active CLIA number.
Section 8.0: Document upload is required for a newly added CLIA record.
Section 10.0: To Esign and Submit, active CLIA records require a physical address.
In compliance with
KRS 205.532, the Kentucky Department for Medicaid Services (DMS) implemented the
KY MPPA system allowing all provider types to enroll, revalidate and perform maintenance electronically. The
KY MPPA complies with all federal and state requirements, policies and procedures related to provider enrollment, revalidation and maintenance.
KY MPPA requires a provider email address to be associated with the provider KY Medicaid number (existing and new) and is required to secure accounts. The email address cannot be the credentialing contact email address, only the providers'. Prescribing providers already use an email address for KASPER through KY Online Gateway. For these provider types, this is the preferred email.
Enrolling New Kentucky Medicaid Providers
- Review the
provider type summary for your provider type to understand the documentation required to enroll.
- Review the
training resources to help navigate the KY MPPA.
- Download multifactor authentication software.
- Create an account and start an application on the KY MPPA.
How long will the enrollment process take?
The enrollment process may take up to 60 days or longer if the documentation or information is not complete or correct. Any outstanding accounts receivable must be settled before the application can be approved. Please refer to
KRS 205.532 (4) (a) for more information on the enrollment timeline.
Current Kentucky Medicaid Provider
Do you need to make an update or revalidate your current Medicaid Provider information, such as:
You will need to update or revalidate your account through the
Updating a State License
When Kentucky Medicaid providers update their licenses, they must submit a copy of the license to Kentucky Medicaid through KY MPPA to keep their provider information updated.
Providers licensed through any of the licensing boards listed below that have updated their licenses through their respective boards at least 15 working days prior to the expiration date and no later than the last day to renew, will not be required to submit licensure verification to DMS until revalidation or maintenance is necessary. Otherwise, the license verification must be submitted to DMS through KY MPPA.
Kentucky Board of Nursing
Kentucky Board of Medical Licensure
Kentucky Board of Pharmacy
Kentucky Board of Dentistry
Kentucky Board of Examiners of Psychology
Kentucky Board of Speech-Language Pathology and Audiology
Kentucky Board of Licensure for Professional Art Therapists
Kentucky Board of Alcohol and Drug Counselors
Kentucky Applied Behavior Analyst Licensing Board
Kentucky Board of Licensed Professional Counselors
Kentucky Board of Licensure for Marriage and Family Therapists
Kentucky Board of Licensure for Occupational Therapy
Kentucky Board of Opthalmic Dispensers
Kentucky Board of Specialists in Hearing Instruments
Kentucky Board of Durable Medical Equipment Suppliers
Kentucky Board of Podiatry
Kentucky Board of Chiropractic Examiners
Note: Providers with out-of-state licenses must submit updated license information through the