Thank you for your interest in becoming a provider with AHCCCS. On this page you will find information about how to apply to become an AHCCCS registered provider, What to Expect When Applying in AHCCCS Provider Enrollment Portal (APEP), as well as what to expect after you become an approved provider.
In general, the process to become an AHCCCS registered provider and maintain your enrollment is as follows:
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Providers new to APEP: |
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Existing APEP users: |
If you need to reset your APEP Password, please see the APEP Password Reset Procedure.
If you need to add, change, or remove a Domain Administrator, please see Domain Access in APEP (PEP-901).
If you are unable to use APEP to submit your application, the AHCCCS Provider Enrollment Application form may be used. The form will only be accepted if the provider has extenuating circumstances that explain why they cannot use the AHCCCS Provider Enrollment Portal System (APEP). Circumstances must be outlined in a written statement along with submission of the AHCCCS Provider Enrollment Application form with Provider Participation Agreements Attached (PEP-202.1).
Providers are required to make arrangements for and only accept payment by way of electronic funds transfer (EFT) within 30 calendar days following the effective date of the agreement that is signed upon submitting an enrollment application. Active providers will be given a grace period to comply with this requirement. All active providers will receive a notice from AHCCCS explaining how to enroll in EFT. Upon receiving this notice, an active provider will be required to comply with the EFT requirement within 30 days of the notice.
To prepare for the AHCCCS Provider Enrollment application, have the following documentation available when you apply:
Each applying provider must be screened based on their assigned risk level. The general screening requirements for each risk level are outlined below.
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Section 6401(a) of the Affordable Care Act (ACA) requires the State Medicaid Agency to impose a fee on each “institutional provider of medical or other items, services, and suppliers.” The application enrollment fee amount is the same fee that applies to Medicare enrollment. The enrollment fee does not include non-institutional providers (e.g., Practitioners, Dentist, Group Billers). The purpose of the enrollment fee collected by the State Medicaid Agency is to offset the cost of conducting the required screening for the provider application. The enrollment fee is collected during the new enrollment, revalidation, and reactivation of a disenrolled provider.
The fee amount increases each calendar year and is issued by the Centers for Medicare and Medicaid Services (CMS). The enrollment fee for calendar year 2024 is $709, effective January 1, 2024 through December 31, 2024.
You can review the Provider Enrollment Screening Glossary (PEP-903) to identify which providers require the enrollment fee.
To pay the enrollment fee, please visit the following webpage: Make an online payment
A refund of the application fee may be issued for any of the following reasons:
To request a refund of the application fee, submit a ticket by email to apeptrainingquestions@azahcccs.gov with the subject “Application Fee Refund.” The request must include all the following information:
If you do not include all the information listed above, the ticket will be closed. You will need to complete and submit a new ticket to request the refund of the application fee.
You will receive a response once your request has been processed. When approved, a paper check is issued by AHCCCS. The refund process may take 30 to 60 days.
AHCCCS generally processes Provider Enrollment applications within 60 days of submission. An expedited application process may be requested. Some examples of what may justify an expedite includes (but is not limited to):
Follow the steps below to request an expedited application:
Any requests missing the required information will not be processed. The email request should be sent to APEPTrainingQuestions@azahcccs.gov Once your email has been submitted, you will receive a ticket number confirmation. It’s important that you do not resubmit an email for the same reason, as this will impact the timeliness of your request
In general, the effective date of AHCCCS enrollment is the date the application is approved. In some instances, a retroactive enrollment date may be requested. All requests are reviewed on a case-by-case basis. Some examples of what may justify a retroactive enrollment include (but are not limited to):
This list is not all available reasons why a retroactive enrollment date may be considered. These are examples and not a guarantee of a retroactive enrollment.
Before requesting a retroactive enrollment date, there must be a completed Provider Enrollment Application in the AHCCCS Provider Enrollment Portal (APEP) and all required screening and enrollment steps for the AHCCCS Provider Enrollment process must be completed.
To request a retroactive enrollment date, send an email to APEPTrainingQuestions@azahcccs.gov with “Retroactive Enrollment Date” as the subject line. The email must include all the following information:
Provide any additional information or supporting documentation that may be needed to complete the retroactive enrollment request. Failure to submit supporting documentation with the request will result in the request being denied.
After being approved as an AHCCCS registered provider, you are required to:
A provider must revalidate their enrollment every four years to maintain Medicaid billing privileges. AHCCCS reserves the right to request off-cycle revalidations.
During revalidation, screening is based on the current risk level for the provider type. Based on provider type the screening requirements may include an enrollment fee, site visit, and fingerprint criminal background check. Revalidations also require the provider to review all information on file and confirm the information is correct. Providers may log into the AHCCCS Provider Enrollment Portal (APEP) to view revalidation dates.
