July 16, 2026

Beginning Aug. 13, 2026, as a participating provider, you’ll be able to add new practitioners and service locations to your practice information through our new online Provider Data Intake form.

Through the form, you can:

• Add new practitioners to an existing participating group

• Add new service locations to existing participating facilities or groups

• Save your progress and return later to finish your request

• Upload multiple practitioners or locations using a downloadable roster template

• Track request status in real time

• Access and view previously submitted requests

• Download PDF copies of your requests for recordkeeping and compliance purposes

Keep an eye on our News page for updates and instructions on how to use the form.