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)
• Non-participating provider emergency services payment guidance (PDF)
• Provider reference guide (PDF)

Important contact information

Provider Services
1-800-521-6007

Prior authorization
1-800-521-6622