New Providers

Applications from new, reenrolling and revalidating Medicaid providers are processed in accordance with state regulations 13 CSR 65-2 and 13 CSR 70-3.020.  Reenrollment is different than revalidation.  A reenrolling provider is an individual or institution that was previously active, but is in an inactive status at the time an application is submitted to MMAC.  Revalidation means there is no break in active status.  All currently enrolled (active) MO HealthNet providers must go through a revalidation process at least every five (5) years to continue to be a MO HealthNet provider.

At this time, select provider types can currently enroll electronically:

Apply to be a Missouri Medicaid Provider

Providers who cannot currently enroll electronically should request an application package by submitting an e-mail to:


Applications and Forms

Application Fee

Provider Assigned Risk Categories

Site Visits

Fingerprint Based Criminal History Checks