Provider Enrollment Application Fee Increased for 2024
The enrollment application fee for institutional providers for the 2024 calendar year has increased from $688 to $709. This application fee will be required in the following instances:
- Initial enrollment, reactivation, revalidation or reenrollment of providers in Medicaid and the Children’s Health Insurance Program (CHIP)
- Addition of New Owners – Change of Ownership
- Providers adding a new Medicaid practice location
Note: Simple changes to the provider enrollment information, that is, new phone numbers, new bank account information, new billing address, change in the name of the provider or other such updates are not subject to the fee.
Providers required to submit a fee are:
| Taxonomy | Description |
|---|---|
| 251E00000X |
Home Health |
| 251G00000X |
Hospice Care, Community Based |
| 261QA1903X |
Clinic/Center – Ambulatory Surgical |
| 261QE0700X |
Clinic/Center – End-Stage Renal Disease (ESRD) Treatment |
| 261QF0400X |
Clinic/Center – Federally Qualified Health Center (FQHC) |
| 261QM0801X |
Clinic/Center – Mental Health (Including Community Mental Health Center) |
| 261QR0401X |
Clinic/Center – Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| 261QR1300X |
Clinic/Center – Rural Health |
| 282N00000X |
General Acute Care Hospital |
| 283Q00000X |
Psychiatric Hospital |
| 291U00000X |
Clinical Medical Laboratory |
| 293D00000X |
Physiological Laboratory |
| 314000000X |
Skilled Nursing Facility |
| 314000000X |
Skilled Nursing Facility |
| 3140N1450X |
Skilled Nursing Facility – Nursing Care, Pediatric |
| 332B00000X |
Durable Medical Equipment and Medical Supplies |
| 333600000X |
Pharmacy |
| 341600000X |
Ambulance |
Providers submitting their application fee should make their check out to the Mississippi Division of Medicaid, annotating on the check the application tracking number (ATN) and mail to Gainwell Technologies, PO Box 6014, Ridgeland, MS 39158. Providers who have already paid the application fee to Medicare or another state’s CHIP or Medicaid program have fulfilled the requirement and do not have to pay the fee to Mississippi Medicaid.
For more information, call the Provider and Beneficiary Services Call Center at 1-800-884-3222 or your designated field representative: https://medicaid.ms.gov/wp-content/uploads/2022/12/Provider-Field-Representatives.pdf if you need assistance.
