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Iowa Admin. Code r. 441-79.14 - Provider enrollment
(1) Application request. Iowa Medicaid providers, including those enrolled with a managed care organization, shall begin the enrollment process by
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470-4389 Consumer-Directed Attendant Care (CDAC)
This form is to record the services you provide. It is required that you fill out one of these forms every day that you provide services. Your billings may.
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470-0254, Iowa Medicaid Universal Enrollment Application
If the Tax ID is already enrolled and active, the following form is required: □ Form 470-0254, Iowa Medicaid Universal Provider Enrollment Application (Section
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