To enroll a Dialysis Center (Out-of-State) in New York State Medicaid, you must send a Remittance Advice (UB-04) showing hemodialysis services were provided and that the eligibility was verified for the Client. Send Remittance Advice (UB-04) to the New York State Department of Health Rate Based Provider Bureau, 150 Broadway, Suite 6E, Albany, NY 12204. You must also have a CMS or Home-State Operating Certificate. Once reviewed and approved, an enrollment package will be mailed to the address provided.
Please Note: Existing providers have the option of billing new programs or services with an NPI already enrolled with the NY State Medicaid Program or an NPI unknown to NYS Medicaid. To report an unknown NPI, an enrollment application will be sent to you to complete and return to Medicaid's fiscal agent, Computer Sciences Corportion (CSC). Adding a new service or program to an enrolled NPI may require completion of other enrollment documents. Please contact the Rate Based Provider Bureau at (518) 474-3575, option 4 or (800) 342-3005, option 4 if you have any questions regarding these NPI options.
