Provider Publications
~/ProviderPricing/ProviderPublications
Provider Bulletins
~/Public/Bulletins
Forms
~/ProviderPricing/ProviderPublications#prvForms
Manuals
~/Public/ProviderManuals
HIPAA Guide
~/ProviderPricing/HIPAACompanionGuides
Member Publications
~/Public/MemberPublications
Publications

 

Provider Manuals

The Provider Manuals page is divided into two sections: Current Manual Type and Discontinued Manual Type. Both current and discontinued manuals have historical versions available. All discontinued manuals no longer contain active information and are strictly available for historical purposes. The latest version of the current manual contains the most up-to-date information. Search manual types alphabetically by clicking on the arrow to the right of the drop-down box.

Forms
Bulletins
Provider Enrollment Applications

Thank you for your interest in becoming a Kansas Medicaid Provider. Use the links below to start a new application or to complete a revalidation.


Start a New Online Application or Revalidation


Other forms that may be required to complete an enrollment can be found here


Provider Enrollment Help and Information


Enrollment Wizard Tips


The links below contain details of the required attachments for all applications displayed by provider type.




Enrollment Applications - Enrollment Requirement Documents

        PT 01 - Hospital
        PT 20 - Audiologist
        PT 02 - Ambulatory Surgical Center
        PT 21 - Targeted Case Management
        PT 03 - Custodial Care
        PT 22 - Hearing Aid Dealer
        PT 04 - Rehabilitation Facility
        PT 23 - Nutritionist
        PT 05 - Home Health Agency
        PT 24 - Pharmacy
        PT 06 - Hospice
        PT 25 - Durable Medical Equipment
        PT 07 - Capitation Provider
        PT 26 - Transportation Provider
        PT 08 - Clinic
        PT 27 - Dentist
        PT 09 - Advance Practice Nurse
        PT 28 - Laboratory
        PT 10 - Mid-Level Practitioner
        PT 29 - X- Ray Clinic
        PT 11 - Mental Health Provider
        PT 30 - Renal Dialysis Center
        PT 12 - Local Education Agency
        PT 31 - Physician
        PT 13 - Public Health Agency
        PT 32 - Non-Physician
        PT 14 - Podiatrist
        PT 45 - Qualified Medicare Beneficiary
        PT 15 - Chiropractor
        PT 53 - Head Start Facility
        PT 17 - Therapist
        PT 55 - Home and Community Based Services
        PT 18 - Optometrist
        PT 56 - WORK
        PT 19 - Optician
Training Materials

 

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