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Provider Enrollment > Portable X-Ray Provider

Provider Enrollment



Option 1

Demonstration Providers ...

To participate in the Portable X-Ray Demonstration Project which allows you to provide services to beneficiaries with NYS Medicaid coverage only.

NOTE: To provide services to beneficiaries with NYS Medicaid coverage only, complete Options 1 and 2.

Click here for the Enrollment Form and Instructions.

Option 2

Freestanding Providers ...

Services provided to QMB's only (Qualified Medicare Beneficiaries). This service is NOT available to all Medicaid beneficiaries or individuals with Medicare Part B.

NOTE: To provide services to beneficiaries with NYS Medicaid coverage only, complete Options 1 and 2.

Click here for the Enrollment Form and Instructions.

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