Pennsylvania Medical Assistance
Credentialing and enrollment guides for Pennsylvania Medical Assistance across 1 states.
Quick Overview
Timeline
30 - 60 days
CAQH
Not Required
Re-credentialing
Every 5 year(s)
States Available
1
About Pennsylvania Medical Assistance
Pennsylvania DHS — Medical Assistance (MA)
How to Get Credentialed
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and board certifications.
Prepare Your Application
Complete Pennsylvania Medical Assistance's provider enrollment application with all required information and supporting documentation.
Submit Your Application
Submit your completed enrollment package to Pennsylvania Medical Assistance. Select your state below for state-specific submission details.
Track & Follow Up
Credentialing typically takes 30-60 days. Monitor your application and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Pennsylvania Medical Assistance?
Our specialists handle the entire Pennsylvania Medical Assistance enrollment process: applications, follow-ups, and approvals across all 50 states.
Required Documents
Background Check
CV/Resume
FINGERPRINT_CLEARANCE
Malpractice Insurance
Required in most states; some state programs waive for government employees
Medical License
NPI Certificate
STATE_CLEARANCE
PA state clearances required for all providers
Enrollment Forms
Pennsylvania Medicaid Provider Enrollment (PROMISe)
Contact Information
Provider Credentialing
1-800-537-8862
Mon-Fri 8am-5pm
Provider Services
1-800-537-8862
Claims & Billing
1-800-537-8862
Need Help?
Let PayerReady handle your Pennsylvania Medical Assistance credentialing and enrollment.
Get Started NowAvailable States
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.
Select Your State
Choose your state for Pennsylvania Medical Assistance-specific credentialing details including timelines, contacts, and local requirements.
Pennsylvania Medical Assistance credentialing requirements by state
Pennsylvania Medical Assistance enrollment is not identical everywhere. The table below lists what actually differs across the 1 state Pennsylvania Medical Assistance operates in — network status, local plan names, portals and the state-specific conditions our credentialing team has recorded.
| State | Network | Timeline | State-specific notes |
|---|---|---|---|
| Pennsylvania | Open | 30–60 days | Pennsylvania Medicaid (HealthChoices) enrollment steps: (1) Obtain NPI via NPPES. (2) Register through the DHS (Department of Human Services) PROMISe (Provider Reimbursement and Operations Management Information System in Electronic) provider enrollment portal. (3) Submit application with PA state license, proof of malpractice insurance, and required documentation. (4) Complete three background checks: Act 34 (PA State Criminal History), Act 151 (Child Abuse History Clearance), and FBI fingerprint check required for all providers. Pennsylvania operates managed care through HealthChoices with 5 MCOs per geographic zone. Behavioral health providers accepted include LPC, LCSW, and LMFT with active Pennsylvania licensure. Revalidation is required every 5 years. |
Compiled and maintained by the PayerReady credentialing team from payer portals and direct payer contact. Last verified March 22, 2026. Network status changes without notice — confirm before you file.
Common questions about Pennsylvania Medical Assistance credentialing
How long does Pennsylvania Medical Assistance credentialing take?
Pennsylvania Medical Assistance credentialing typically takes 30–60 days from a complete submission to an approved effective date. Incomplete applications are the main cause of delay: a missing document or an unattested CAQH profile restarts the clock rather than pausing it.
Does Pennsylvania Medical Assistance require CAQH?
No. Pennsylvania Medical Assistance does not enroll through CAQH ProView, so credentialing data is submitted directly on Pennsylvania Medical Assistance's own application instead. You still need the same underlying documents — license, DEA where applicable, malpractice coverage and work history.
Which states does Pennsylvania Medical Assistance operate in?
Pennsylvania Medical Assistance has credentialing operations in 1 state. 1 of those 1 currently show an open panel. Requirements are not uniform: local plan names, provider portals and state-specific conditions differ, which is what the state-by-state table above records.