Provider Enrollment

Optometrist (OPT) — Individual Billing Medicaid

If you do/will bill fee-for-service (FFS) Medicaid, click here for the Enrollment Form and instructions.

Optometrist (OPT) — 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.

Optometrist (OPT) 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.