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This document outlines the changes to Medi-Cal provider enrollment applications and application fees effective January 1, 2013, including compliance with provisions of the Affordable Care Act regarding
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How to fill out revised medi-cal provider enrollment

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How to fill out Revised Medi-Cal Provider Enrollment Applications and New Application Fees

01
Obtain the Revised Medi-Cal Provider Enrollment Application from the California Department of Health Care Services website.
02
Fill out the application form with accurate information regarding your practice or healthcare organization.
03
Ensure that you include all required documentation, such as proof of licensing and certifications.
04
Double-check all entries for accuracy to avoid delays in processing.
05
Submit the application through the designated submission method, which may be online or via mail.
06
Pay the applicable new application fee as outlined in the application instructions, ensuring payment methods are accepted.

Who needs Revised Medi-Cal Provider Enrollment Applications and New Application Fees?

01
Healthcare providers seeking to enroll or re-enroll in California's Medi-Cal program.
02
Organizations that provide healthcare services and wish to bill Medi-Cal for their services.
03
Individuals or entities needing to update their provider information in the Medi-Cal system.
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Application Fee for Calendar Year 2025 This fee amount is established by the Centers for Medicare & Medicaid Services (CMS) for each calendar year and the new $730.00 amount is required with any applicable enrollment application submitted on or after January 1, 2025 and on or before December 31, 2025.
This is the place to start your own journey to a successful college career — ​ and a degree. The fee to apply to the CSU is $70 per campus.
The Department estimates Medi-Cal spending to be $179 billion total funds ($37.4 billion General Fund) in 2024-25 and $194.5 billion total funds ($44.6 billion General Fund) in 2025-26. This does not include Certified Public Expenditures of local governments or General Fund expenditures in other state departments.
Application fees & waivers The application fee is $80 for each UC campus ($95 for international and non-immigrant applicants). You can make your payment either by credit card or by mail, just be sure follow the instructions in the application.
The Provider Application and Validation for Enrollment (PAVE) system is an interactive, web- based solution for the provider types who enroll with Medi-Cal through PED and manage their Medi-Cal accounts securely online.
The undergraduate application fee is $85, payable online via the Common Application when you submit your application for admission. The fee applies to all applicants, regardless of state of residency or citizenship status.

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Revised Medi-Cal Provider Enrollment Applications are forms that healthcare providers must complete to enroll or re-enroll in the Medi-Cal program. New Application Fees are charges associated with processing these applications.
All healthcare providers who wish to participate in the Medi-Cal program, including individual practitioners, group practices, and organizations, are required to file the Revised Medi-Cal Provider Enrollment Applications and pay the associated New Application Fees.
To fill out the Revised Medi-Cal Provider Enrollment Applications, providers should carefully follow the instructions provided with the application form, ensuring all sections are completed accurately. They must also include any necessary documentation and payment for the New Application Fees.
The purpose of the Revised Medi-Cal Provider Enrollment Applications is to gather essential information from healthcare providers to facilitate their enrollment in the Medi-Cal program. The New Application Fees help to cover the administrative costs associated with processing these applications.
Providers must report various information on the Revised Medi-Cal Provider Enrollment Applications, including their personal and practice details, verification of licenses and certifications, tax identification numbers, and any additional documentation as required, along with the payment of New Application Fees.
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