2020 Provider Enrollment Application Fee

PROVIDER ALERT

The Centers for Medicare and Medicaid Services (CMS) has announced the enrollment application fee amount for calendar year 2020 will be $595. This fee is required with any applicable Healthy Connections Medicaid provider enrollment application.

The South Carolina Department of Health and Human Services (SCDHHS) will collect the application fee before executing a provider agreement. The fee applies to initial enrollment, reactivation, revalidation or addition of a new practice location. SCDHHS has contracted with the SC.gov Enterprise Payment System to facilitate collection of the application fee. Payments may be made by debit, credit or e-check. Paper checks will not be accepted. More information on payment options can be found by visiting www.scdhhs.gov/provider and selecting, “Online Application Fee Payment.

The provider enrollment application fee is only applicable to providers CMS has identified as institutional providers. South Carolina Healthy Connections Medicaid recognizes and enrolls the following institutional providers:

Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Durable Medical Equipment, End Stage Renal Disease Facilities, Federally Qualified Health Centers, Home Health Agencies, Hospice, Hospitals, Independent Clinical Laboratories, Pharmacies, Skilled Nursing Facilities and Rural Health Clinics.

The application fee is not required for providers who meet the following criteria:

  1. Individual physicians (sole proprietors enrolling with a Social Security Number [SSN] and Employer Identification Number [EIN] are considered individuals), non-physician practitioners and non-physician practitioner organizations.
  2. Providers who are enrolled in or have already paid the application fee to Medicare and/or another state's Medicaid agency or Children's Health Insurance Program (CHIP) for the same enrollment location jurisdiction.
  3. Providers who have submitted and received approval for a Hardship Waiver request.

SCDHHS' goal is to continue to enhance the integrity of the Healthy Connections Medicaid program while complying with federal requirements. If you have any questions regarding provider enrollment and screening, please contact the Provider Service Center at (888) 289-0709, option 4, or visit www.scdhhs.gov/provider for additional information.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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