New York Medicaid Provider Enrollment: 2026 Step-by-Step PSP Guide

Quick Reference

The NYS Medicaid program moved provider enrollment to the Provider Services Portal, or PSP, in 2025 and opened it to all provider types in 2026. Paper enrollment is ending, and a hard July 2026 cutoff closes the last paper pathway.

Medicaid provider enrollment in New York now runs through one portal, and every provider type follows the same digital path.

Providers who submit on outdated forms or miss PSP's internal timers lose their application start date and restart from zero. A restart adds three to four months of lost Medicaid billing capacity, so the details below map straight to cash flow.

This guide walks through ny medicaid provider enrollment as it works today: the seven-step PSP process, the FFS versus OPRA decision, the $750 2026 application fee, MCO credentialing, the revalidation changes effective May 1, 2026, and the return reasons eMedNY lists in its own bulletins.

Every figure, form number, and deadline below comes from eMedNY and NYS DOH guidance current to mid-2026.

A provider who reads it before opening PSP avoids the errors that send applications back.

Why New York Medicaid Provider Enrollment Changed in 2026

Three modernization waves rebuilt New York's Medicaid enrollment between September 2025 and July 2026. These dates reset what new york state medicaid provider enrollment looks like in practice, and the medicaid provider registration process now starts and ends inside one portal.

• September 8, 2025: PSP Phase 1 launched. New individual practitioners who had never enrolled in NYS Medicaid could apply through the portal, and paper turned into the slower option.
• October 30, 2025: eMedNY published its first eMedNY provider enrollment bulletin, naming the top reasons applications came back: incorrect signature, an incomplete ownership section, EFT upload errors, and missing DEA certificates.
• March 27, 2026: PSP Phase 2 opened to all provider types. Groups, institutions, and businesses gained portal access, while group practices with a single NYS Medicaid-enrolled practitioner kept filing on paper.
• May 1, 2026: Paper revalidation submissions ended. Any provider due for revalidation on or after that date waits for PSP outreach by USPS and email.
• May 7, 2026: NYS Medicaid released updated paper forms. Applications on outdated versions received on or after May 27, 2026 can come back, and reinstatements need the provider's eight-digit Provider ID.
• July 2026: All paper enrollment applications stop, with no exceptions.

NYS DOH documents these milestones in the September 2025 NYS Medicaid Update and the April 2026 NYS Medicaid Update.

Every week of delay in NY Medicaid enrollment is a week of Medicaid services a practice can't bill. The July 2026 deadline is a hard wall, and a practice that misses it loses paper as a fallback.

Each MCO that screens against the state database can drop an unenrolled provider, so the deadline reaches managed care too. For how this varies across states, see our Medicaid provider enrollment guide.

FFS Billing, OPRA, or Managed Care Only: Which NY Medicaid Enrollment Type Do You Need?

Every provider picks one of three NYS Medicaid enrollment tracks before opening PSP. Medicaid provider enrollment in New York starts with this single choice, and the wrong pick costs months.

FFS Billing Provider (individual billing Medicaid): a provider who submits claims to NYS Medicaid and gets paid. This is the standard track for physicians, nurse practitioners, PAs, therapists, dentists, and other billing providers. FFS enrollment through PSP sets up the ETIN, EFT authorization, and ePACES access for claims.

OPRA Provider (ordering, prescribing, referring, attending): a provider who writes orders, prescriptions, or referrals for Medicaid beneficiaries and does not submit claims. Federal rules require OPRA enrollment even when the provider never bills Medicaid. When an OPRA provider's NPI isn't on file with NYS Medicaid, the payer can deny the billing provider's claims.

Managed Care Only: a provider who joins a Medicaid managed care organization's network and does not bill fee-for-service Medicaid. This track still requires state enrollment first, because MCO credentialing builds on it.

The wrong track delays billing, and in some cases forces a full re-enrollment. Lock this choice before Step 1 of the PSP application. Providers who bill and also order can hold one billing enrollment that already covers ordering, so they don't file twice.

How to Enroll in New York Medicaid Through the PSP: 7 Steps

Medicaid new york provider enrollment runs through seven steps inside PSP, from NPI verification to the final DOH review. The seven steps below are the full New York Medicaid provider enrollment path, and each one hides a specific failure point.

Step 1: Obtain Your National Provider Identifier Through NPPES

Every NYS Medicaid application needs an active NPI registered with the National Plan and Provider Enumeration System. Individuals use a Type 1 NPI; groups and organizations use a Type 2. The taxonomy code on the NPI record has to match the specialty the provider plans to bill, or PSP rejects the application.

Step 2: Create a NY.gov Business Account for PSP Access

PSP access runs through a NY.gov Business Account, not a personal one. Account setup involves identity proofing, multi-factor authentication, and email verification. The process takes 10 to 20 minutes and happens once. After the account goes active, the provider signs in at nysproviderportal.health.ny.gov.

Step 3: Access the Provider Services Portal and Start Your Application

Inside PSP, the provider selects a provider type and starts the enrollment application. PSP assigns a 14-digit Application ID right away. Write it down. The ID is the only way to track progress, answer DOH requests, and recover the application if the browser session drops.

Step 4: Obtain Your Electronic Transmitter Identification Number

An ETIN lets a provider submit claims through eMedNY and reach ePACES. New enrollees complete Certification Statement Form 490602; providers joining an existing group use Form 490501. The ETIN stays inactive until eMedNY confirms setup, so hold every Medicaid claim until that confirmation lands. eMedNY lists both forms in the eMedNY Provider Enrollment Guide.

Step 5: Upload Required Documents and Complete All Application Fields

PSP requires uploads for licenses, certifications, DEA certificates where they apply, the EFT Authorization form, and prior conduct disclosures. Every mandatory field has to be complete before submission. PSP returns incomplete applications without processing. Section 10 below lists the return triggers that catch providers most.

Step 6: Submit the Application and Monitor Status Through PSP

The provider, the authorized owner, or a managing employee has to click submit inside PSP. Office staff and billing agents can't submit for the provider without triggering a signature rejection. After submission, the provider tracks ny medicaid provider enrollment progress using the Application ID.

Step 7: Respond to DOH Requests Within 45 Days

When DOH asks for more information, the provider has 45 days to answer through PSP. An unanswered request withdraws the application, and the provider restarts the whole thing. Check the PSP inbox and the registered email daily across the 90 to 120 day review window.

MedSole's team manages the entire New York Medicaid provider enrollment process, responds to DOH requests within 24 hours, and clears return reasons before they cause delays. Our NY Medicaid provider enrollment services handle every step at $99 per payer.

Required Documents for NY Medicaid Provider Enrollment in 2026

Completing a medicaid provider registration in New York means uploading every item below before PSP accepts the file. PSP lists exact upload specifications on the eMedNY Provider Services Portal.

Required for all provider types

• Active NPI registration (Type 1 for individuals, Type 2 for organizations), verified in NPPES with the correct taxonomy code.
• Active professional license or registration from the relevant NYS licensing board.
• W-9 form or IRS EIN confirmation.
• EFT Authorization Form (new enrollees only; not required at revalidation when EFT is on file and unchanged).
• ETIN Certification Statement Form 490602 (providers never previously enrolled).

Required for applicable provider types

• DEA Certificate (providers who prescribe, administer, or dispense controlled substances; providers who don't prescribe complete Form EMEDNY 610301 instead).
• Prior Conduct Questionnaire Form 431001 (when the provider answers yes to any conduct disclosure in PSP).
• Group Member Affiliation Form 610202 (group practice members; one form per additional group).

Institutional and organizational providers only

• Ownership and Control disclosure (SSN, home address, and date of birth for every disclosed owner).
• Hospital, Nursing Home, or Clinic-Based Questionnaire (provider-type specific).
• Pharmacy Primary Screening Form (pharmacies only).

An outdated version of any form, received on or after May 27, 2026, triggers a return.

Three PSP Timers That Can End Your NY Medicaid Application Before Approval

PSP runs three internal timers that delete, withdraw, or reject enrollment applications, and most providers never learn they exist.

Timer 1: The 20-Day Submission Timer (Application Auto-Deletion)

An application started in PSP but not submitted within 20 days gets deleted. The provider starts over, and the old Application ID goes invalid. The clock runs from the moment the provider opens the application inside PSP, not from the first document upload.

Timer 2: The 45-Day Response Timer (Application Withdrawal)

After submission, DOH reviews the file and may request more information. When the provider doesn't answer through PSP within 45 days, DOH withdraws the application. A withdrawn application can't come back, so the provider files new and restarts the 90 to 120 day window. Anyone who checks their medicaid provider application status after that point finds it marked withdrawn.

Timer 3: The May 27, 2026 Form Version Deadline (Automatic Return)

Applications on outdated paper forms, meaning versions dated before May 2026, that reach eMedNY on or after May 27, 2026 can come back unprocessed. A returned application doesn't keep its original start date. The provider resubmits with a new date and loses position in the review queue.

All three timers point to one risk for an in-house team: a missed notification or a slow upload can add three to four months of lost Medicaid billing. MedSole's provider enrollment and credentialing services track every timer and answer every DOH request within 24 hours, so providers keep their start date.

The 2026 NY Medicaid Provider Enrollment Application Fee: $750, Exemptions, and Hardship Waivers

The 2026 application fee tied to New York Medicaid provider enrollment is $750 for institutional providers. Medicaid provider enrollment fees in New York follow the federal schedule, so the amount matches what CMS sets nationwide.

The $750 fee applies to institutional providers that enroll, revalidate, or add a practice location. It rose from $730 in 2025, and CMS adjusts it each year using the Consumer Price Index for All Urban Consumers under 42 CFR 455.460. PSP prompts the provider when the fee applies.

Physicians and non-physician practitioners, including nurse practitioners and physician assistants, are exempt from the application fee. Providers already enrolled in Medicare or another state's Medicaid or CHIP program are exempt too. A provider who paid the fee to another state Medicaid program for the same service location can claim the exemption with proof.

Providers who face financial hardship can request a waiver by notifying eMedNY in writing. eMedNY forwards the request to CMS for review. The waiver isn't automatic and isn't guaranteed. A provider waiting on a hardship decision should keep submitting; CMS doesn't hold the application during review. The official figure sits on the eMedNY application fee schedule.

Paying the fee on an application that later gets returned over a form version or a signature issue means paying it again on resubmission.

How to Check NY Medicaid Provider Enrollment Status in 2026

Three tools show ny medicaid provider enrollment status in 2026: the PSP portal, the Medicaid Pending Provider Listing, and the eMedNY Call Center. Each tool reports provider enrollment status at a different level of detail.

1. Through PSP: providers sign in at nysproviderportal.health.ny.gov with their NY.gov Business Account and open the application tracking screen using the 14-digit Application ID. Status shows as In Process, Pending, Active, Denied, or Withdrawn. The portal is the fastest way to read medicaid provider application status in real time.
2. Through the Medicaid Pending Provider Listing: providers under review appear on a searchable public directory on the NYS DOH site that the State updates weekly. MCOs check this listing to confirm which providers are in process before they drop anyone from a network.
3. Through the eMedNY Call Center: providers call (800) 343-9000 for a status update. Hold times run longer during the submission surges that follow major transition announcements.

For the MCO credentialing layer that runs alongside state enrollment, our guide to Medicaid credentialing experts covers the parallel process in full.

A pending status means DOH received the application and placed it in the review queue. Pending providers can keep seeing patients, but they can't bill Medicaid FFS until the status turns Active. An MCO may keep a provider in-network during the pending period when the provider shows on the Pending Provider Listing, though this varies by plan.

A denied application produces a written DOH determination naming the specific reason. Providers can reapply after fixing that reason. A denial doesn't disqualify a provider from future enrollment.

Providers who want real-time provider enrollment status without managing PSP can route follow-up through MedSole's credentialing team, which sends written status reports every two weeks on each active application.

New York Medicaid MCO Credentialing: The Second Enrollment Nobody Tells You About

State enrollment through PSP gives a provider access to NYS Medicaid fee-for-service billing. It doesn't enroll the provider in any managed care organization's network.

These two processes run at the same time, and both finish before a provider can bill across the full range of NYS Medicaid patients in a service area. The state New York Medicaid provider enrollment through PSP and the MCO credentialing track are separate approvals.

Under the 21st Century Cures Act, every provider in a Medicaid managed care network also enrolls with the State Medicaid agency. MCOs screen each network provider against the State enrollment database. A provider who isn't enrolled with NYS Medicaid can lose an MCO network slot regardless of existing MCO credentialing, a requirement published in the April 2026 NYS Medicaid Update.

New York's Medicaid managed care market includes Healthfirst, MetroPlus Health Plan, EmblemHealth, Fidelis Care, Molina Healthcare, and UnitedHealthcare Community Plan, alongside smaller regional MCOs.

Each plan runs its own credentialing application on its own 90 to 120 day timeline, separate from the state enrollment clock. A provider entering a new New York market can face enrollment and credentialing timelines across five or more payers at once.

To get credentialed with Medicaid managed care plans in New York, providers finish both state enrollment and each MCO application. Medicaid credentialing for providers in New York runs through two distinct approvals.

A practice that clears PSP in 90 days but hasn't started MCO credentialing in that same window stays locked out of managed care billing for another 90 to 120 days after state approval. Sequencing these processes instead of running them in parallel can cost a new provider six to eight months of Medicaid revenue.

MedSole manages the state PSP application and each MCO credentialing track at the same time. Our managed Medicaid enrollment at $99 per payer covers both layers, so providers don't lose the parallel credentialing window while state approval is pending.

NY Medicaid Provider Revalidation in 2026: What Changed on May 1

Federal rules require NYS Medicaid to revalidate every enrolled provider at least every five years, and the submission process moved into PSP on May 1, 2026. 42 CFR 455.414 sets the cycle, which ties to the provider's enrollment anniversary, not a fixed calendar year.

Providers find the next expected date on the Medicaid Enrolled Provider Listing, though eMedNY notes the date is an estimate and shifts as the eMedNY provider enrollment file updates. For providers dual-enrolled in Medicare and Medicaid, our Medicare provider enrollment guide covers the parallel revalidation timeline under PECOS.

Paper revalidation submissions ended on May 1, 2026. Providers whose revalidation came due between February 1 and April 30, 2026 and hadn't submitted were told to take no action and wait for PSP outreach. From May 1 forward, revalidation runs through PSP, and providers get notice by USPS and email before the window opens.

Providers keep the correspondence address and email on the enrollment file current. A revalidation notice sent to an old address means a missed deadline.

A missed deadline terminates the provider from Medicaid and strips ordering, prescribing, referring, and attending privileges. Your New York Medicaid provider enrollment status flips to terminated when revalidation lapses, and the lapse also pulls the provider from Medicaid managed care networks.

MedSole tracks revalidation dates for every enrolled provider and files through PSP before the window opens.

Why NY Medicaid PSP Applications Get Returned and How to Prevent Each One

According to eMedNY's October 2025 provider enrollment bulletin, a handful of errors send most new applications back for correction. These returns slow Medicaid provider enrollment for in-house teams more than any coding error, and each one triggers a 60 to 90 day restart cycle.

1. Incorrect signature. An office staffer, billing agent, or representative submitted instead of the provider or authorized owner or managing employee. Prevention: confirm the person signed into PSP is the provider or named signatory before the submission step.
2. Incomplete ownership section. The SSN, home address, or date of birth of a disclosed owner was left off, and PSP doesn't flag those fields before submission. Prevention: fill every ownership field before uploading documents.
3. EFT step errors. The provider uploaded an outdated EFT form instead of completing the banking step inside PSP, and bank letters without notarization come back. Prevention: use PSP's built-in EFT step and upload a voided check or bank letter only when PSP asks.
4. Missing DEA certificate. A provider who prescribes, administers, or dispenses controlled substances left the DEA certificate out of the upload. Prevention: providers without controlled-substance privileges still complete Form EMEDNY 610301 to confirm they don't need DEA certification.
5. Outdated form version. Paper forms dated before May 2026, received on or after May 27, 2026, come back regardless of whether the content is correct. Prevention: download every form from eMedNY.org the day of submission.

MedSole's enrollment team checks every application against these exact return reasons before submission, the same rigor that carries into every layer of medicaid credentialing for providers MedSole manages. Our medical billing and credentialing services guide shows how clean applications connect to faster first-claim payment.

NY Medicaid Compliance in 2026: OMIG Requirements Every Enrolled Provider Must Know

The NYS Office of the Medicaid Inspector General requires a compliance program under Social Services Law Section 363-d and 18 NYCRR Subpart 521-1. The rule covers hospitals, residential health care facilities, home care services agencies, providers of developmental or mental disability services, and any provider claiming at least $1 million in Medicaid services in any 12-month period.

OMIG plans about 200 compliance program reviews in 2026 under its published work plan. Providers unsure whether they cross the threshold can use the self-assessment on the OMIG compliance program requirements page.

Providers no longer file a separate annual December compliance certification form through OMIG. OMIG eliminated that requirement. Providers now attest to Section 363-d compliance inside the annual Certification Statement for Provider Billing Medicaid, filed on the enrollment anniversary.

The DRA certification folded into Section 363-d, which ended the separate DRA filing. The regulatory basis sits on the OMIG compliance certification requirements page.

NYS DOH policy bars offshore credentialing staff from reaching any State system tied to provider enrollment or Medicaid billing. The rule covers any provider or RCM organization using teams outside the United States to run enrollment workflows.

This reaches every enrolled provider, including those using outsourced medicaid credentialing for providers. Providers who rely on offshore credentialing support confirm their setup complies before routing PSP access to those teams.

MedSole's enrollment team is domestic and complies with this NYS DOH policy in full.

New York Medicaid Provider Enrollment Contacts, Resources, and How MedSole Can Help

Ny medicaid provider enrollment runs across the PSP application, MCO credentialing for six or more plans, revalidation tracking, compliance attestation on the enrollment anniversary, and EFT setup before the first claim goes out.

MedSole RCM handles every layer at $99 per payer enrollment and full-cycle medical billing at 2.99% of collections, with no setup fees, no annual contracts, and the fastest approval timelines in the market.

Frequently Asked Questions About New York Medicaid Provider Enrollment in 2026

How do I enroll as a NY Medicaid provider in 2026?

Providers who have never enrolled in NYS Medicaid apply through the Provider Services Portal at nysproviderportal.health.ny.gov. The seven-step process starts with an active NPI, requires a NY.gov Business Account, and produces a 14-digit Application ID for tracking. Paper applications end in July 2026.

How long does NY Medicaid provider enrollment take in 2026?

PSP review runs 90 to 120 days from a complete submission to an Active determination. Incomplete applications, missing documents, or unanswered DOH requests restart the clock. Starting MCO credentialing alongside the PSP submission cuts the total time to full Medicaid billing, the window most medicaid provider enrollment files share.

What is the NY Medicaid application fee in 2026?

The 2026 application fee is $750 for institutional providers. Physicians and non-physician practitioners are exempt. Providers already enrolled in Medicare or another state Medicaid program also qualify for an exemption. PSP prompts providers when the fee applies, so the initial medicaid provider registration carries no separate payment step.

Can I still submit a paper application for NY Medicaid enrollment?

Group practices with a single NYS Medicaid-enrolled practitioner can file paper until July 2026. Every other provider type uses PSP for new enrollment now. After July 2026, no paper pathway remains. Outdated form versions received on or after May 27, 2026 come back without processing, so ny medicaid provider enrollment runs through PSP.

What does NY Medicaid enrollment status pending mean?

Pending status means DOH received the application and placed it in the review queue. Pending providers appear on the searchable Medicaid Pending Provider Listing, updated weekly, and MCOs check it to confirm who's in process. Pending providers can see patients but can't bill Medicaid FFS until the provider enrollment status turns Active.

Do I need separate NY Medicaid MCO credentialing after state enrollment?

Yes. State enrollment through PSP covers fee-for-service billing only. Each Medicaid managed care organization in New York, including Healthfirst, MetroPlus, EmblemHealth, Fidelis Care, Molina, and UnitedHealthcare Community Plan, runs its own 90 to 120 day credentialing timeline. Running both at once helps providers get credentialed with Medicaid faster, the heart of medicaid credentialing for providers.

What is the phone number for NY Medicaid provider enrollment questions?

The eMedNY Call Center handles enrollment questions at (800) 343-9000. Providers can also email providerenrollment@health.ny.gov. For PSP technical issues, eMedNY recommends calling the Call Center with the 14-digit Application ID ready. eMedNY provider enrollment training webinars sit on the eMedNY Provider Training calendar at no cost.