New York State Medicaid Update - April 2020 Special Edition Volume 36 - Number 8

New York State Medicaid Program Launches Online Medicaid Provider Enrollment During COVID-19 Public Health Emergency

The health and safety of New York State's health care workforce and the ability to provide and support patient care remain priorities. This system upgrade offers an improved and more streamlined process for providers interested in offering Medicaid services.

Pursuant to section 1135(b)(1)(B) of the Social Security Act, the Centers for Medicare and Medicaid Services (CMS) has allowed states to temporarily waive and/or suspend some of the requirements for providers who wish to temporarily enroll in fee-for-service (FFS) Medicaid for the purpose of assisting with the COVID-19 public health emergency. As a result, and to expedite and simplify the enrollment process, the Department of Health's Bureau of Provider Enrollment has taken action to implement the following:

  1. Create an online Provisional Temporary Provider Enrollment application process that allows physicians, registered physician assistants (RPAs), nurse practitioners (NPs), registered nurses (RNs), and licensed practical nurses (LPNs) to enroll on a temporary basis for the purpose of assisting with COVID-19 activities;
  2. Allow a retroactive effective date no earlier than March 1, 2020, for Provisional Temporary Provider Enrollments;
  3. Waive application fees for Provisional Temporary Provider Enrollment applications;
  4. Waive the screening requirements of site visits and fingerprint-based Criminal Background Checks for Provisional Temporary Provider Enrollments;
  5. Allow providers who are enrolled in either Medicare or another state's Medicaid program to enroll in NY Medicaid as Provisional Temporary providers;
  6. Allow providers who are licensed outside of New York State to render services to Medicaid members during the public health emergency as Provisional Temporary providers;
  7. Allow credentialing offices to submit multiple provider enrollments using a spreadsheet, provided by eMedNY; and
  8. Enroll providers who are not enrolled in Medicare or another state's Medicaid program if the requested data is provided on the Provisional Temporary Provider Enrollment application and the provider: 1) is not currently excluded from NYS Medicaid; 2) does not appear on the Office of Inspector General (OIG) Exclusions Database; and 3) is licensed and legally authorized to practice or deliver the service for which they file claims in at least one state or territory.

The Provisional Temporary Provider Enrollment (PTPE) Process

PTPE is only available for the duration of the public health emergency. Once the designation is lifted, PTPEs will cease, and providers enrolled under this process will be required to complete the full application process or will be terminated from the NY Medicaid program.

PTPE is only available to providers in the following Categories of Service (COS):

  • Nurse LPN – 0521
  • Nurse RN – 0522
  • Nurse Practitioner – 0469
  • Physician – 0460
  • Physician Assistant (Registered) – 0462

Before completing any PTPE application, the Pending Providers List or Enrolled Practitioners Search must be reviewed to ensure the provider is not already enrolled in New York State Medicaid. If the provider appears on either list, the provider does not need to enroll under this process. Please note that submitting applications for providers who are already enrolled will divert resources from processing the applications of providers who do need to enroll.

PTPE Enrollment

For each of below described PTPE enrollment options, the following information is required:

  • Provider's/credentialer's email address
  • Provider's responses to the disclosure questions
  • Category of Service (COS)
  • Provider's SSN
  • Name of state where provider is licensed for the COS on application
  • License number
  • Provider's National Provider Identifier (NPI)
  • Provider's date of birth
  • Provider phone numbers: cell, work
  • For physicians, NPs, and RPAs only, if affiliated to a group, the group name, group NPI, and whether the provider also has a private practice
  • Home address (optional), correspondence address, pay-to address, taxpayer address, and name and address of service location

Please Note: If any of the above information is missing or not available, processing of the application will be delayed.

For each of the PTPE enrollment options (1-4), providers are required to answer standard enrollment disclosure questions. A provider who answers "yes" to any disclosure question, or a provider who currently appears on the NYS excluded provider list and is seeking reinstatement, cannot enroll using the PTPE process but rather is required to complete and submit both the full paper application and the Prior Conduct Questionnaire. It is important to note that upon processing of the PTPE application, a written determination of approval or denial will be sent to the correspondence address.

Options for Submitting PTPE Applications

Option 1 - To Enroll Using the Online Form:

  1. An online form for both billing and OPRA providers can be accessed at:
  2. Instructions for completing and submitting the online form are found below the link to the form on the website.
  3. To complete the online application process, the provider must click "Submit".

Option 2 - To Enroll Using Email:

  1. The Department has created fillable PDF files of the Practitioner Enrollment Form (billing providers) and the OPRA Enrollment Form (ordering, prescribing, referring, and/or attending providers) that are available at:
  2. Only certain fields are required to be completed. Please be sure to refer to the instructions found directly below the PDF files' links.
  3. Completed forms should be saved, attached to an email, and forwarded for processing to:

Option 3 - To Enroll an Individual Provider by Telephone:

To complete an application by telephone, providers and/or credentialers are asked to contact the eMedNY Call Center at(800) 343‑9000 , menu option 2, sub option 4. If enrolling by telephone, the required provider-specific information (listed above) must be available before calling.

Option 4 - To Enroll Multiple Providers:

  • Credentialers who are enrolling multiple providers must contact the eMedNY Call Center at 800 343‑9000 for assistance. A spreadsheet will be provided by eMedNY, and the credentialer must complete the required fields for each provider who is applying for PTPE.
  • Credentialers must check the Pending Providers List or perform the Enrolled Practitioners Search for each provider to make sure the provider is not already enrolled. If the provider appears on either list, the provider does not need to enroll under this process. Please note that submitting applications for providers who are already enrolled will divert resources from processing the applications of providers who do need to enroll.

Option 5 - Online Provider Portal in Development:

Prior to the COVID-19 emergency, the Department was working on developing an online provider portal to replace the existing paper-based enrollment process and fully automate provider enrollment for all providers. In response to the current public health emergency, the Department refocused this development initiative to quickly implement provisional temporary enrollments. The option for full enrollment through the Online Provider Portal is in development. Please check the Provider Enrollment tab on the eMedNY website regularly for updates on this option, as well as other pertinent information related to provider enrollment activities during this emergency.

Questions about Provisional Temporary Provider Enrollment:

  • Questions related to this guidance should be sent to Please include "COVID-19" in the subject line.
  • Questions related specifically to completing or submitting PTPE applications should be directed to the eMedNY Call Center at (800) 343‑9000 or

The Medicaid Update is a monthly publication of the New York State Department of Health.

Andrew M. Cuomo
State of New York

Howard A. Zucker, M.D., J.D.
New York State Department of Health

Donna Frescatore
Medicaid Director
Office of Health Insurance Programs