Provider Enrollment

Dietitian / Nutritionist — Individual Billing Medicaid

If you do/will provide medical services and the services you provide will be billed to Medicaid by you or by a group practice, Click Here for the Enrollment Form and instructions. This option allows a provider to bill Medicaid directly and also meets the Medicaid enrollment prerequisite for participation in a Medicaid Managed Care network and allows the Dietician/Nutritionist to provide services as an attending provider for an Article 28 facility or group practice.

Dietitian / Nutritionist — Non Billing - Ordering/Prescribing/Referring/Attending (OPRA) or Managed Care Network Provider

If you will NOT be billing fee-for-service (FFS) Medicaid, click here for the Enrollment Form and instructions.

Dietitian / Nutritionist — Change From Non Billing (OPRA or Managed Care Network Provider) To Billing Provider

If you are already enrolled as a non-billing OPRA or managed care network provider and wish to bill fee-for-service Medicaid, click here for the Enrollment Form and instructions.