Note: If you are enrolling solely for the purpose of ordering, prescribing or referring services for Medicaid members, see the Ordering, Prescribing or Referring Providers page for more for special instructions.

If you are enrolling to receive gas mileage reimbursement for transporting a family member or close associate to medical appointments, see the Family Member/Associate Transportation Providers page for special instructions.

This page provides steps for submitting an Indiana Health Coverage Programs (IHCP) provider enrollment application – either online or by mail. A full enrollment application is required for the following transactions:

• To enroll as an IHCP provider for the first time
• To add a service location for an existing IHCP provider
• To convert an existing enrollment from the Ordering, Prescribing, Referring (OPR) classification to the Rendering classification
• To report a change of ownership (CHOW) for an existing IHCP provider
• To revalidate an enrollment, as required (see the Provider Enrollment Revalidation page)

For instructions on updating the information on file for an existing enrollment, see the Update Your Provider Profile page.

Enrollment Steps

The following steps outline the basic process for enrolling as a provider in the Indiana Health Coverage Programs (IHCP). For information about the various provider types and specialties that are eligible for IHCP enrollment, as well as the classifications under which they may enroll, see the Provider Classification, Type and Specialty page.

1. Obtain a National Provider Identifier (NPI), if needed. An NPI is required for all healthcare providers; it is not required for atypical providers (such as waiver or transportation specialties). For instructions and additional information, see the National Provider Identifier page.


2. Gather all required documentation. Refer to the IHCP Provider Enrollment Type and Specialty Matrix for a list of documentation required for IHCP enrollment or revalidation under each applicable provider specialty. The matrix includes special documentation requirements for providers located outside Indiana, and indicates which specialties are ineligible for out-of-state enrollment; see the Become an IHCP Provider page for more information about out-of-state enrollment.


3. Determine your risk level and application fee requirements and take necessary actions. Refer to the IHCP Provider Enrollment Risk Category and Application Fee Matrix to determine the risk level associated with your specialty and whether you are required to pay an application fee. (Note: At its discretion, the IHCP may assign a provider a higher risk level that supersedes the risk level indicated on the matrix.) Complete the following, if required:
   • Fingerprint background check – Providers classified as “high risk” are  subject to Medicaid fingerprint background checks. All individuals with at least 5% ownership or controlling interest in the enrolling entity must complete Medicaid fingerprinting activities before the enrollment application is submitted. The fingerprinting confirmation number must be included on the application. See Provider Enrollment Risk Levels and Screening for fingerprinting instructions.
   • Application Fee Payment – Providers that are subject to an application fee must submit confirmation of electronic payment of the fee to the IHCP (or documentation that they have paid the fee to Medicare or another state Medicaid program). A separate application fee is required for each service location at initial enrollment, revalidation, and in the event of a change of ownership. See the Provider Enrollment Application Fee page for more information, including the current year's fee.
4. Complete and submit your application. The IHCP offers two ways to enroll:
   • Apply online (recommended). Providers are encouraged to use the IHCP Provider Healthcare Portal (IHCP Portal) to enroll, as the online application process is much quicker and easier than applying by mail. Online help guides users through the process from start to finish and provides immediate confirmation of enrollment submissions. To begin, click the link below to go to the IHCP Portal homepage, click Provider Enrollment and then click Provider Enrollment Application:

   IHCP Portal –
   Online Enrollment

   • Apply by mail. If you choose to enroll by mail, you must submit the appropriate provider enrollment packet. Use the IHCP Provider Enrollment Packet Finder to access the correct packet for the provider type, specialty and classification under which you wish to enroll:

   IHCP Provider Enrollment 
   Packet Finder

   The IHCP provider packet is an interactive PDF file, allowing you to type information into the fields electronically, save the file to your computer, and print the completed file to be signed and mailed. Detailed instructions are included in the packet. Be sure to make a copy of the completed packet and all supporting documentation for your records. Then mail the packet, along with all required documentation, to the following address:

   IHCP Provider Enrollment
   PO Box 50443
   Indianapolis, IN 46250-0418

5. Wait for your application to be processed. See the Application Processing Procedures section of this page.


6. Apply to enroll as a managed care provider (optional but recommended). After you are enrolled as an IHCP provider, if you are interested in enrolling as a provider with the IHCP's managed care program, you must apply directly to one or more of the managed care entities (MCEs). Please see the Enrolling as a Managed Care Program Provider page for information about the MCEs with which the state of Indiana contracts for each managed care program. Links to the MCE enrollment forms follow – use the form appropriate for your provider type:
   • IHCP MCE Practitioner Enrollment Form
   • IHCP MCE Hospital/Ancillary Provider Enrollment and Credentialing Form

Application Processing Procedures

Please allow at least 15 business days for processing before checking the status of your submission. After your transaction is processed, the IHCP Provider Enrollment Unit will notify you of the results.

• If the submission needs correcting or is missing required documentation, the Provider Enrollment Unit will contact you by telephone, email or mail. This contact is intended to communicate what needs to be corrected, completed and submitted before the IHCP can process your application.
  • If you are enrolling via the IHCP Portal and your submission is rejected for missing or incomplete information, the submission must be corrected in the portal. Providers will have 21 business days to make corrections, or the application will expire.
  • If you are enrolling via paper, a letter will be sent indicating what needs to be corrected or attached. Providers must attach a copy of this letter as a cover sheet when they submit the missing or corrected pages.


• If the submission is complete, the Provider Enrollment Unit will process the application, conduct the appropriate screening associated with your assigned risk level, and make a determination:
  • If the IHCP approves your enrollment or revalidation, you will receive a verification letter from the Provider Enrollment Unit.
  • If the IHCP denies your enrollment or revalidation, you will receive a notification letter explaining the reason for denial. If you believe your enrollment or revalidation was denied in error, you may appeal. See the Provider Enrollment provider reference module for information about the appeal process.

Note: Letters from the IHCP Provider Enrollment Unit are sent in envelopes that display the Indiana Family and Social Services (FSSA) logo and the words "IMPORTANT MEDICAID INFORMATION INSIDE."