To comply with provisions of the Affordable Care Act (ACA) regarding enrollment and screening of providers (Code of Federal Regulations: 42CFR, §455.410), effective December 31, 2013, all providers MUST be enrolled in the Pennsylvania State Medicaid program before a payment of a Medicaid claim can be made. This applies to non-participating out-of-state providers as well.
You can enroll in the Pennsylvania State Medicaid program.
- Become a participating provider
- Claims filing instructions (PDF)
- Member eligibility verification information (PDF)
- Non-participating provider emergency services payment guidance (PDF)
- Provider reference guide (PDF)
Important contact information