Medicaid

How to Get Credentialed with Medi-Cal in California

Network: Open
60-90 Days

Quick Overview

Timeline

60 - 90 days

CAQH

Not Required

Re-credentialing

Every 5 year(s)

Delegated

No

California-Specific Requirements

California Medicaid (Medi-Cal) enrollment steps: (1) Obtain NPI via NPPES. (2) Submit application through PAVE (Provider Application and Validation for Enrollment), the DHCS online enrollment system. (3) Complete fingerprint Live Scan background check at an authorized location, required for initial enrollment. (4) Receive Medi-Cal provider number upon approval. Managed care is mandatory in most California counties, requiring separate credentialing with Medi-Cal managed care plans. Behavioral health providers accepted include LMFT, LCSW, LPCC, and Licensed Psychologist with active CA licensure; specialty mental health services are administered through county Mental Health Plans (MHPs). Revalidation is required every 5 years.

Medicaid Information: California

Agency: Department of Health Care Services (DHCS)

Program: Medi-Cal

Portal: https://pave.dhcs.ca.gov

Phone: (916) 323-1945

Step-by-Step Enrollment Process

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for California.

2

Prepare Your Application

Complete Medi-Cal's provider enrollment application with all required information and supporting documentation.

3

Submit Your Application

Submit your completed enrollment package to Medi-Cal.

4

Track & Follow Up

Credentialing typically takes 60-90 days. Monitor your application status and respond promptly to requests for additional information.

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Required Documents Checklist

Background Check

Federal/state background check required for Medicaid enrollment

CV/Resume

Work history required

FINGERPRINT_CLEARANCE

Conditional

Required for high-risk provider types

Fingerprinting required for high-risk provider types

Malpractice Insurance

Conditional

Required in most states; some state programs waive for government employees

Medical License

NPI Certificate

Enrollment Forms

Medi-Cal PAVE Enrollment

Required
Online Open →

Key Credentialing Terms

Capitation
A payment model where a payer pays a provider a fixed amount per member per month regardless of whether the member recei...
CAQH
The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
Credentialing
The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
Effective Date
The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
Managed Care
A healthcare delivery system organized to manage cost, utilization, and quality through techniques such as provider netw...
Network Adequacy
The requirement that a health plan's provider network has enough providers in each specialty and geographic area to give...
NPI
The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
Primary Source Verification
The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...

Credentialing Checklist

Make sure you have everything ready before applying to Medi-Cal.

View Physician Credentialing Checklist →

Contact Information

Provider Credentialing

National

(916) 323-1945

Mon-Fri 8am-5pm

Provider Services

National

(916) 323-1945

Claims & Billing

National

(916) 323-1945

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

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