Federal Provider Enrollment Application Fee for Calendar Year 2022 ACA Requires Provider Enrollment Fee
Based upon provisions of the Affordable Care Act (ACA), a provider enrollment fee must be collected from Medicaid and NC Health Choice providers initially enrolling in, or revalidating their enrollment in, Medicare, Medicaid or NC Health Choice, or adding a new Medicare practice location.
For calendar year 2022, the fee is $631. The Centers for Medicare & Medicaid Services (CMS) sets the fee, which is adjusted annually. The federal fee is required for initial enrollment applications, re-enrollment applications, Manage Change Requests (MCRs) to add a new site location and re-verification applications. This fee only applies to institutional providers. An ‘‘institutional provider,’’ for purposes of Medicare, is defined at § 424.502 as ‘‘any provider or supplier that submits a paper Medicare enrollment application using the CMS–855A, CMS–855B (not including physician and non-physician practitioner organizations), CMS–855S, CMS–20134, or associated internet-based PECOS enrollment application.’’
Additional information can be found on the Federal Register.