How to become a Medicaid provider in New York
To bill New York Medicaid, enroll through NYS Medicaid Provider Services Portal (PSP), run by eMedNY. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- NYS Medicaid Provider Services Portal (PSP)
- Steps
- 6
- Documents
- 4
- Plans listed
- 15
On this page
New York Medicaid enrollment at a glance
To bill New York Medicaid, enroll through NYS Medicaid Provider Services Portal (PSP), run by eMedNY. The process has 6 steps, listed below with the documents the state asks for.
- Program
- New York State Medicaid (NYS Department of Health; eMedNY)
- Enrollment portal
- NYS Medicaid Provider Services Portal (PSP)
- Fiscal agent
- eMedNY (NYS DOH's Medicaid claims system). Revalidation notices come from ProviderEnrollment@acentra.com. The eMedNY pages we reviewed do not name the claims contractor.
- Application fee
- Under 42 CFR 455.460, certain provider types and enrollment transactions owe an application fee, and the PSP tells you when one is due. The fee is waived if the provider is enrolled in Medicare or another state's Medicaid/CHIP program, or already paid the fee to Medicare. A hardship waiver can be requested with the application; New York forwards it to CMS. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.
- Fingerprinting
- High-risk providers undergo a fingerprint-based background check for every owner holding 5% or more. ABA providers, 1915(c) HCBS waiver providers and Licensed Home Care Services Agencies are newly designated high risk. Results of a Medicare screening can count toward fingerprinting.
- Site visit
- Moderate- and high-risk providers get pre- and post-enrollment site visits. Results of a Medicare screening can count toward the site visit requirement.
- Revalidation
- Revalidation frequency depends on risk level: high-risk every 3 years, moderate every 4, limited every 5. Since May 2026 all revalidation is done in the PSP; paper processes have ended. Under an April 2026 CMS directive, every provider is being revalidated over 24 months. Phase 1 covers high-risk, DME and providers not revalidated since the COVID-19 emergency began. Phase 2 (early 2027) covers newly high-risk ABA, 1915(c) HCBS and LHCSA providers. The remaining providers follow through June 2028. Wait for an individual notice before revalidating. Missing the deadline ends enrollment.
- Provider manual
- Provider manual
Steps
- Get an NPI (required; enrolled providers who lack one must get one before revalidating)
- Create a Health Commerce System (HCS) account or an NY.gov business account with multi-factor authentication
- In the eMedNY Provider Index, find your provider type and review its Requirements & Additional Forms
- Fill out the enrollment application in the Provider Services Portal and upload the required documents
- Pay the application fee if the PSP asks for it, or show an exemption
- To serve Medicaid managed care members, contract and credential separately with each plan
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Each Medicaid managed care plan contracts and credentials providers on its own. The DOH and eMedNY pages we reviewed describe no centralized credentialing. Moratoriums in effect: new enrollments are paused for labs, DMEPOS, ABA, LHCSAs, pharmacies and MLTC/MAP/PACE plans, and pending applications in those classes were discontinued.
- Plans (state list)
- Amida Care, Inc. (SNP)
- Capital District Physician's Health Plan, Inc. (CDPHP)
- Excellus Health Plan, Inc.
- Health Insurance Plan of Greater New York, Inc. (EmblemHealth)
- Healthfirst PHSP, Inc.
- Highmark Western and Northeastern New York Inc.
- Anthem HP, LLC (Anthem Blue Cross and Blue Shield HP)
- Independent Health Association, Inc.
- MetroPlus Health Plan, Inc.
- MetroPlus Health Plan, Inc. (SNP)
- Molina Healthcare of New York, Inc.
- MVP Health Plan, Inc.
- New York Quality Healthcare Corporation (Fidelis Care)
- United Healthcare of New York, Inc. (UnitedHealthcare Community Plan)
- VNS Choice SNP
Frequently asked questions
How do I become a Medicaid provider in New York?
To bill New York Medicaid, enroll through NYS Medicaid Provider Services Portal (PSP), run by eMedNY. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in New York Medicaid?
Under 42 CFR 455.460, certain provider types and enrollment transactions owe an application fee, and the PSP tells you when one is due. The fee is waived if the provider is enrolled in Medicare or another state's Medicaid/CHIP program, or already paid the fee to Medicare. A hardship waiver can be requested with the application; New York forwards it to CMS. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.
How often must New York Medicaid providers revalidate?
Revalidation frequency depends on risk level: high-risk every 3 years, moderate every 4, limited every 5. Since May 2026 all revalidation is done in the PSP; paper processes have ended. Under an April 2026 CMS directive, every provider is being revalidated over 24 months. Phase 1 covers high-risk, DME and providers not revalidated since the COVID-19 emergency began. Phase 2 (early 2027) covers newly high-risk ABA, 1915(c) HCBS and LHCSA providers. The remaining providers follow through June 2028. Wait for an individual notice before revalidating. Missing the deadline ends enrollment.