How to become a Medicaid provider in South Dakota
To bill South Dakota Medicaid, enroll through South Dakota Medicaid Provider Enrollment (PE) Portal. The process has 5 steps, listed below with the documents the state asks for.
- Enrollment portal
- South Dakota Medicaid Provider Enrollment (PE) Portal
- Steps
- 5
- Documents
- 5
- Plans listed
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On this page
South Dakota Medicaid enrollment at a glance
To bill South Dakota Medicaid, enroll through South Dakota Medicaid Provider Enrollment (PE) Portal. The process has 5 steps, listed below with the documents the state asks for.
- Program
- South Dakota Medicaid (Department of Social Services, Division of Medical Services)
- Enrollment portal
- South Dakota Medicaid Provider Enrollment (PE) Portal
- Application fee
- SD Medicaid's enrollment page says no application fee is charged. (Federal rule 42 CFR 455.460 allows the fee; CMS set it at $750 for 2026.)
- Fingerprinting
- Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. The SD DSS enrollment page we could reach does not describe a separate state fingerprint process (its maintenance/revalidation page returned an error).
- Site visit
- Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. The SD DSS enrollment page we could reach does not describe a separate state site visit process.
- Revalidation
- Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. SD Medicaid ran a portal-wide revalidation when the PE Portal launched in 2021 (due June 7, 2021). Records that could not be revalidated were terminated, and existing providers did not have to re-sign provider agreements.
- Provider manual
- Provider manual
Steps
- Get an NPI and decide whether you are enrolling a billing NPI (BNPI) or a servicing/rendering NPI (SNPI); many attending, ordering, referring and prescribing providers are enrolled automatically when claims come in
- Start the enrollment record online in the PE Portal
- Email supporting documents to SDMedicaidPE@state.sd.us with the NPI, provider name and whether it is new or existing
- Finish the record and documents within 30 days of starting, or it is denied or rejected
- Keep the online record current. Reviews are generally done in the order received
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- SD Medicaid's enrollment page describes no managed care organizations or plan credentialing. Providers bill SD Medicaid directly. Eligible primary care practitioners sign a PCP Addendum to serve as primary care providers. No centralized MCO credentialing applies.
Frequently asked questions
How do I become a Medicaid provider in South Dakota?
To bill South Dakota Medicaid, enroll through South Dakota Medicaid Provider Enrollment (PE) Portal. The process has 5 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in South Dakota Medicaid?
SD Medicaid's enrollment page says no application fee is charged. (Federal rule 42 CFR 455.460 allows the fee; CMS set it at $750 for 2026.)
How often must South Dakota Medicaid providers revalidate?
Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. SD Medicaid ran a portal-wide revalidation when the PE Portal launched in 2021 (due June 7, 2021). Records that could not be revalidated were terminated, and existing providers did not have to re-sign provider agreements.