Medicaid (Mo HealthNet)

Medicaid (MO HealthNet)

Medicaid Enrollment Application Fee for 2022

On November 19, 2021 Missouri Medicaid Audit and Compliance (MMAC) released a bulletin regarding the collection of application fees from new and revalidating “institutional” Medicaid providers, which states:

  • State and federal regulations (13 CSR 65-2 and 42 CFR 455.460) require Missouri Medicaid Audit and Compliance (MMAC) to collect an application fee from all new and revalidating “Institutional” Medicaid providers. “Individual” providers such as physicians, dentists and other individual non-physician practitioners are not required to pay the application fee. The application fee is currently set at $599, and it will increase to $631 on January 1, 2022. Click here to read more about the application fee and hardship waivers

If I am a Medicaid provider, am I required to pay a fee? The MMAC application and revalidation fee is tied to the NPI type. An individual NPI (dentist) will never be required to pay a fee. Whereas Business or Type 2 NPI are required to pay the fee. For example, if a dentist owns a business and that business NPI is enrolling to be Fee for Service, there is an enrollment fee. If the business NPI is enrolled to be Managed Care only (MCO), there is no enrollment or revalidation fee.