Revision History and Archives

This page provides a summary of changes that have been made to this manual. Entries are added according to the date they were published. At the end of each entry you will find a link to a PDF file that archives the policy as it existed prior to the revision.

Revisions Date 02/03/2026

PEPM111 Provider Types [PT 06] Emergency Transportation

• Information added regarding the ADHS Certificate of Necessity renewal. 

 

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 01/20/2026

PEPM302 Types of Modifications [Section A] Change in Ownership

• Step/Action table added for reporting a change of ownership. 

 

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 12/16/2025

PEPM105 Application Fees

• Application fee updated for 2026.

 

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 10/21/2025

PEPM111 Provider Types [PT 08] MD Physician

• Electronic Funds Transfer (EFT) added to Requirements. Clinical Laboratory Improvement Amendments (CLIA) Certificate added to Pathology & Lab Category of Service (COS).

PEPM113 National Provider Identifier (NPI)

• Language added instructing providers that an NPI application requires a taxonomy code. The taxonomy code listed in the APEP application should match the code listed in the NPPES. Term and definition added for “Taxonomy Code.”

 

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 08/12/2025

PEPM203 Approval of Applications

• Effective Dates section updated with examples of what may justify a retroactive enrollment date. Proof section updated with requirements before a retroactive enrollment date can be requested.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 08/05/2025

PEPM106 Fingerprint-Based Criminal Background Checks

• All managing employees of municipalities added to list of providers that require a criminal background check. Proof section updated to three years for previously submitted fingerprints to be accepted.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 04/01/2025

PEPM100 Introduction

• Taxpayer Identification Number (TIN) added to overview.

PEPM114 Taxpayer Identification Number (TIN)

• New section added for Taxpayer Identification Number (TIN) information.

PEPM205 Reenrollment

• Text added to reflect retroactive enrollment dates.

PEPM302 Types of Modifications [Section A] Change in Ownership

• Policy updated with information regarding when a provider gets a new TIN.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 02/25/2025

PEPM111 Provider Types [PT 40] Attendant Care

• Note added to clarify when a provider can add COS 31.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 01/31/2025

PEPM111 Provider Types [PT 02] Hospital

• Updated name for JCAHO.

PEPM111 Provider Types [PT 71] Psychiatric Hospital

• Updated name for JCAHO.

PEPM111 Provider Types [PT 78] Mental Health Residential Treatment Center (RTC)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B1] Residential Treatment Center Secure (17+ Beds)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B2] Residential Treatment Center Secure (1-16 Beds)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B3] Residential Treatment Center Non-Secure (17+ Beds)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B5] Subacute Facility (1-16 Beds)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B6] Subacute Facility (17+ Beds)

• Updated name for JCAHO.

PEPM111 Provider Types [PT B7] Crisis Services Provider

• Updated name for JCAHO.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 01/30/2025

PEPM111 Provider Types [PT 02] Hospital

• License/Certification for COS 47 updated.

PEPM111 Provider Types [PT 71] Psychiatric Hospital

• License/Certification for COS 47 updated.

PEPM111 Provider Types [PT C4] Specialty Per Diem Hospitals

• Electronic Funds Transfer (EFT) added to Requirements. License/Certification for COS 47 updated.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual

Revisions Date 01/29/2025

PEPM111 Provider Types [PT 02] Hospital

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [03 Pharmacy] Psychiatric Hospital

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT 78] Mental Health Residential Treatment Center (RTC)

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B1] Residential Treatment Center Secure (17+ Beds)

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B2] Residential Treatment Center Secure (1-16 Beds)

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B3] Residential Treatment Center Non-Secure (17+ Beds)

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B5) Subacute Facility (1-16 Beds) 

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B6] Subacute Facility (17+ Beds)

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT B7] Crisis Services Provider

• Electronic Funds Transfer (EFT) added to Requirements.

PEPM111 Provider Types [PT C4] Specialty Per Diem Hospitals

• Electronic Funds Transfer (EFT) added to Requirements.

 

For prior versions of the Provider Enrollment manual use this link:

Prior Version of the Provider Enrollment Policy Manual