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Application Fee Information

The enrollment application fee must be collected prior to executing a provider agreement whether upon an initial enrollment, reactivation, or revalidation or an enrollment to add a new practice location.

The fee is applicable to providers that the Centers for Medicare & Medicaid Services (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, Hospices, Hospitals, Independent Clinical Laboratories, Pharmacies, Skilled Nursing Facilities and Rural Health Clinics.

This requirement does not apply to:

  1. Individual physicians (sole proprietors enrolling with an EIN and SSN are considered individuals) or non-physician practitioners.
  2. Providers who are enrolled or have paid the application fee to Medicare and/or another state’s Medicaid or CHIP for the same enrollment location jurisdiction.
  3. Providers who have submitted and received approval for a Hardship Waiver request.

Year: 2019
Amount: $586 per application

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