Credentialing in Mississippi

Behavioral health is carved IN: the 2025 MSCAN/CHIP comparison chart lists "Behavioral Health Services" as a plan benefit row at all three CCOs ("Mental Health and Substance Use Disorder Services… Will cover all services currently covered by Mississippi Medicaid").

2025 MSCAN/CHIP Comparison Chart (revised 06.26.2025) · checked Jul 2026

Mississippi Medicaid is run by the Division of Medicaid (DOM). Providers "Submit your application with the appropriate taxonomy through the MESA portal". The fiscal agent is Gainwell Technologies (800-884-3222), and application status is tracked by ATN.

Mississippi Division of Medicaid, Providers · checked Jul 2026

"DOM has contracted with three coordinated care organizations (CCOs), Magnolia Health, Molina Healthcare and TrueCare, who are responsible for providing services to beneficiaries who participate in the MississippiCAN program". The same three carriers run CHIP. Mandatory populations must pick one of the three CCOs; optional groups may choose a CCO or stay fee-for-service, and certain waiver members stay out.

Mississippi Division of Medicaid, Managed Care · checked Jul 2026

"All providers must undergo a revalidation screening process at least once every five years in accordance with 42 C.F.R. § 455.414."

Miss. Admin. Code Title 23 Part 200, General Provider Information · checked Jul 2026

None. Miss. Code Ann. § 83-41-409, the managed-care credentialing statute, contains no decision clock: it only obliges plans to file a summary of the plan credentialing criteria, process and policies, disclose whether practice profiles are used, and provide a denial-review process. No deadline, no deemed-approval, no retroactive pay.

Miss. Code Ann. § 83-41-409 (FindLaw republication, current through 2025-01-01) · checked Jul 2026

None, and the legislature tried and failed: HB 883 (2025) would have authorized the direct on-site supervisor of a provider awaiting a credentialing decision with an MCO to sign off on the work and let the provider be reimbursed for it, but its final action was "02/04 (H) Died In Committee."

Mississippi Legislature, HB 883 (2025) bill history · checked Jul 2026

Mississippi's credentialing rule is the state uniform credentialing application requirement under Code of Miss. Rules Chapter 011 (98.1), carriers accept the uniform application, MID-approved supplemental forms, and hospital-privilege verification. It is the only Mississippi credentialing rule listed in UnitedHealthcare's 50-state credentialing regulatory addendum (rev. 4/2026), which lists no decision-deadline statute for the state.

UnitedHealthcare Credentialing Plan State & Federal Regulatory Addendum (rev. 4/2026) · checked Jul 2026

"Provisionally Licensed Professional Counselors (P-LPC) may provide services within the scope of their provisional license" (with the same sentence pattern for provisionally licensed MFTs), while LMSW appears only as CMHC/PMHC staff; DMH provisional-certificate therapist tiers "must be under the supervision of certified therapist of the same discipline" (certificate valid no more than 24 months). Whose NPI goes in the rendering field for P-LPC/LMSW services is unknown in the vault record, the rule carries no claim-field sentence.

Miss. Admin. Code Title 23 Part 206, Mental Health Services · checked Jul 2026

Two behavioral health boards: the Mississippi State Board of Examiners for Licensed Professional Counselors (LPC, with the provisional tier P-LPC) and the Mississippi State Board of Examiners for Social Workers and Marriage and Family Therapists (LCSW/LMSW plus LMFT and provisional LMFT).

Miss. Admin. Code Title 23 Part 206, Mental Health Services · checked Jul 2026

Mississippi is a Counseling Compact member (on the counselingcompact.gov jurisdictions list) but was NOT yet issuing compact privileges as of July 2026.

Counseling Compact, Compact Jurisdictions · checked Jul 2026

Community mental health services are delivered through "Quasi-governmental Community Mental Health Center (CMHC) agencies and private mental health centers (PMHCs) certified according to Mississippi Code Ann. § 41-4-7 by the Mississippi Department of Mental Health (DMH)"; DMH "issues a four (4) year certification for CMHCs/PMHCs."

Miss. Admin. Code Title 23 Part 206, Mental Health Services · checked Jul 2026

DOM runs centralized credentialing for managed care: "You must be credentialed through the Division of Medicaid before you can contract/enroll with any of the CCOs." Providers give a CAQH ID at MESA enrollment (or use a DOM-contracted delegated credentialing agency), then activate plans inside the portal via the "CCO Selection" characteristic and sign each CCO's contract. There are no three separate plan credentialing cycles to chase.

MS DOM, How to Enroll/Contract with TrueCare · checked Jul 2026

Enrollment includes "Provider Screening Procedures (42 C.F.R. §§ 455.400-470), based on the category of the provider type, which includes license verifications… fingerprinting and criminal background checks, and/or unscheduled or unannounced site visits". An expired license means a denied application.

Miss. Admin. Code Title 23 Part 200, General Provider Information · checked Jul 2026

DOM's Feb-2026 Additional Enrollment Requirements Checklist carries no provisional-tier individual taxonomy: individually enrollable behavioral health taxonomies are Counselor-Professional, LPC/LMFT, Social Worker Clinical, Marriage & Family Therapist, and psychologists, plus organizational Community Behavioral Health / Clinic-Center Mental Health types (including CMHC). Provisional clinicians (P-LPC, LMSW) therefore have no individual Mississippi Medicaid enrollment door.

MS DOM, Additional Enrollment Requirements Checklist (Feb 2026) · checked Jul 2026

"A provider that has not rendered services as evidenced on claims… for a one (1) year period will be disenrolled". Re-enrollment starts from scratch, so dormant enrollments (locums, telehealth overflow providers) silently die.

Miss. Admin. Code Title 23 Part 200, General Provider Information · checked Jul 2026

Timely filing is 365 days, and newly enrolled providers may bill only for dates of service on or after the enrollment effective date.

Miss. Admin. Code Title 23 Part 200, General Provider Information · checked Jul 2026

"TrueCare will join Molina and Magnolia as a Coordinated Care Organization (CCO)… effective July 1, 2025. At that time, UnitedHealthcare will no longer provide coverage for Mississippi members." TrueCare is "a Mississippi-based, non-profit, provider-sponsored health plan… established through a coalition of hospitals and health systems across the state and… supported by CareSource's national expertise."

MS DOM, How to Enroll/Contract with TrueCare · checked Jul 2026