Non-Participating Providers
To comply with provisions of the Affordable Care Act (ACA) regarding enrollment and screening of providers (Code of Federal Regulations: 42CFR, §455.410), 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.
Resources
- Become a participating provider
- Claims filing instructions (PDF)
- Participant eligibility verification information (PDF)
- Provider reference guide (PDF)
Important contact information
Provider Services
1-800-521-6007
Prior authorization
1-800-521-6622