Section 6401(a) of the Affordable Care Act (ACA) requires the State Medicaid Agency to impose a fee on each “institutional provider of medical or other items or services and suppliers.” The fee is to be used by the State Medicaid Agency to cover the cost of program integrity efforts including the cost of screening associated with provider enrollment processes, including those under section 1866(j) and section 1128J of the Social Security Act. Based upon provisions of the ACA this fee will vary from year-to-year based on adjustments made pursuant to the Consumer Price Index for Urban Areas (CPI-U). The application fee is imposed on institutional providers that are newly-enrolling, re-enrolling/re-validating, or adding a new practice location for applications received on and after March 25, 2011. The new application fee for CY2021 is $599.
You can review the Provider Enrollment Screening Glossary to outline which providers trigger the enrollment fee requirement by provider type.
Q. What is the current enrollment fee amount for CY2021?
A. $599, in full.
Q. Do I pay before or after receiving an AHCCCS ID number?
A. The Enrollment fee is required after your application has been submitted and reviewed by AHCCCS.
Q. Will I receive notification to pay the enrollment fee?
A. Yes, you will be notified in writing within instructions on how to make the enrollment fee payment.
Q. What are the acceptable methods of payment to AHCCCS?
A. You can pay with Credit/Debit card, Visa, Master Card, American Express, or enter a bank account number to make a payment. For the bank account payment option, you will need your account number and the bank routing number. Cash, checks and money orders are not acceptable forms of payment and will be returned causing a delay in the process of the application.
Q. What if I have paid the enrollment fee to Medicare?
A. If the enrollment fee has already been paid to Medicare, please indicate on the provider enrollment application.
Q. What if I have paid the enrollment fee to another Medicaid agency?
A. If the enrollment fee has already been paid to another State Medicaid Agency, please indicate on the provider enrollment application the state and attach proof of payment.