Initial Fee for New Enrollees:

• $200 base fee per application.
• An additional $100 per medical physician for each application with a maximum of $3,000.
  • Example: Single physician practice $300
  • Three (3) physician practice $500
  • Forty (40) physician practice: $3,000

Annual Renewal Fee:

• For practices with 1 to 3 physicians $100
• For practices with 4 to 9 physicians $250
• For practices with greater than 10 physicians $500