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Welcome » November 30, 2023 3:52 PM

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	To Start a New Medicaid Enrollment
	Select the link below to start the enrollment process. Applicants have the ability to save their application and return later to finish. Medicaid/Border Status Provider Enrollment Application

	To Start a New In-State Emergency/Out-of-State Enrollment
	Select the link below to start the enrollment process. Applicants have the ability to save their application and return later to finish. Medicaid In-State Emergency/Out-of-State Enrollment Application

	To Start a New Prescribing/Referring/Ordering Enrollment
	Select the link below to start the enrollment process. Applicants have the ability to save their application and return later to finish. Physicians and other professionals who only prescribe, refer, or order services and who are not interested in full Medicaid enrollment may apply for limited Medicaid enrollment as a prescribing/referring/ordering provider. This type of enrollment does not allow Wisconsin Medicaid to reimburse you for your services. Medicaid Prescribing/Referring/Ordering Provider Enrollment Application

	To Start a New Provider Agency Identification Process
	Select the link below to start the enrollment process. This link is for providers who do not need to enroll in Medicaid but need to obtain a Medicaid ID number for Electronic Visit Verification (EVV) purposes. New Provider Agency Identification Process

To Continue a Previous Medicaid Enrollment

Enter your Enrollment Key and Password and select Login.
Enrollment process will start from the beginning; however, previously entered data will be displayed for review.
ADAP enrollment cannot be completed in this section. Please start a new ADAP Provider Certification Application to enroll as an ADAP provider.


Enrollment Key	Enrollment Key: Minimum characters required is (0 ).
Password

	To Start a New ADAP Enrollment
	Select the link below to start the enrollment process. Medicaid-enrolled providers must complete a separate application to be an ADAP provider. ADAP Provider Enrollment Application

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Wisconsin Department of Health Services

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