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Welcome » May 21, 2025 7:33 AM

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	Alerts
	Attention supportive home care (SHC) organizations and providers with a unique EVV provider agency ID: Do not enroll with Wisconsin Medicaid yet. Your provider type is not available in the application. DHS will let you know when you can enroll, likely mid-2025. More information about adult long-term care provider enrollment is available on the New Provider Enrollment System for Adult Long-Term Care page. Children’s Long-Term Support (CLTS) Program Providers and County Waiver Agencies: The CLTS Operations Team is available for your questions about submitting prior authorizations (PAs) or claims for CLTS services. Reach the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com. Attention CLTS Providers: The CLTS Prior Authorization Conversion is still processing. If you have any difficulties submitting claims, please contact the CLTS Operations Team at 844-942-5870 or CLTSOperations@gainwelltechnologies.com.

	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.
HDAP enrollment cannot be completed in this section. Please start a new HDAP Provider Certification Application to enroll as an HDAP provider.


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

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

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Wisconsin Department of Health Services

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