State Guide

Credentialing in New York

Enrollment guides for 58 payers operating in New York.

What actually differs in New York

Credentialing advice written for "most states" tends to be wrong here in specific, expensive ways. These are the rules that only apply in New York.

Compare New York's credentialing deadline with every other state

4 sourced rules, each linked to its source

Getting enrolled 3 Rules that decide your timeline 1

4 sourced rules

Every claim on this page links to the statute, rule or agency page it came from. Last checked July 2026.

Want New York handled for you?

A credentialing manager files the applications, chases the payers and tracks your recredentialing dates.

Get started free

90-day enrollment effective-date cap

New York caps the requested enrollment effective date at 90 days before submission (eMedNY enrollment instruction), driven by the state's 90-day timely-filing rule. Claims must be initially submitted within 90 days of the date of service. Far tighter than Texas's 365-day gap closures: a provider cannot backdate enrollment beyond roughly 90 days and still collect, absent a documented delay reason.

eMedNY enrollment instruction via kb/states/ny.md · checked Jul 2026

Behavioral health carve-IN (HARP inside the MCOs)

New York is a carve-IN state: adult behavioral health folded into mainstream Medicaid Managed Care (NYC 2015, rest of state 2016), with HARP (Health and Recovery Plans) as specialty benefit lines for adults with SMI/SUD run by the same MCOs, no separate county or PIHP body. A BH provider needs NYS Medicaid enrollment plus each MCO contract, confirming each plan's HARP line separately for SMI panels.

NYS OMH, Billing Behavioral Health Under Managed Care, via kb/states/ny.md · checked Jul 2026

Medicaid enrollment (eMedNY / PSP + Cures Act dual layer)

NY Medicaid enrollment runs through eMedNY, with the Provider Services Portal (PSP) as the enrollment front-end since May 1, 2026. Under the Cures Act, every Medicaid Managed Care and CHIP network provider must be state-enrolled, MCOs must drop non-enrolled providers, so a solo clinician faces two layers minimum: enroll with NYS Medicaid via PSP, then contract and credential with each MCO. File both in parallel; running them sequentially can cost months of revenue.

eMedNY Managed Care Network Provider Enrollment via kb/states/ny.md · checked Jul 2026

Prompt credentialing (PHL § 4406-d) N.Y. Pub. Health Law § 4406-d

NY Public Health Law § 4406-d gives managed-care plans 60 days from a completed application to say whether the professional is credentialed (21 days after late third-party documentation arrives). The teeth: a newly licensed professional, or one who recently relocated to NY, joining a fully in-network group who is neither approved nor declined within 60 days is DEEMED provisionally credentialed and may participate in-network from day 61, and the plan may not deny their claims after appeal solely as untimely filed. Capture the completed-application receipt date, it starts both clocks. This binds Article 44 managed-care plans, not eMedNY/Medicaid FFS enrollment.

NY PHL § 4406-d (official statute text) via kb/states/ny.md · checked Jul 2026

Want New York handled for you?

A credentialing manager files the applications, chases the payers and tracks your recredentialing dates.

Get started free

Who Runs New York Medicaid Provider Enrollment

50-state research

Enrollment Portal

eMedNY

Operated By

Gainwell Technologies

Platform

eMedNY

New York awarded eMedNY operations to Gainwell as a single source contract that went live in July 2022.

Go to the official New York enrollment portal

From PayerReady's 50-state Medicaid enrollment platform research, verified July 2026. Portal contracts change; where an operator is in transition or not publicly confirmed, we say so rather than guess.

Aetna

Aetna (CVS Health)

Credentialing in New York

What actually differs in New York

Who Runs New York Medicaid Provider Enrollment

Aetna

UnitedHealthcare

Cigna Healthcare

Anthem / Elevance Health

Humana

Centene Corporation

Molina Healthcare

Anthem Blue Cross and Blue Shield (formerly Empire BlueCross BlueShield)

Excellus BlueCross BlueShield

Highmark Blue Cross Blue Shield of Western New York

New York Medicaid

UnitedHealthcare Community Plan

Amerigroup (Anthem)

Aetna Better Health

Molina Healthcare (Medicaid)

WellCare (Centene)

TRICARE

TRICARE East Region (Humana Military)

CHAMPVA

Delta Dental

Cigna Dental

MetLife Dental

Guardian Dental

Aetna Dental

United Concordia

DentaQuest

MCNA Dental

Liberty Dental Plan

Dental Network of America

VSP Vision Care

EyeMed Vision Care

Davis Vision

Spectera / UHC Vision

Optum Behavioral Health

Carelon Behavioral Health

Magellan Health

Evernorth Behavioral Health

Oscar Health

Workers' Compensation

National Government Services (Jurisdiction K/J6)

Noridian Healthcare Solutions (DME A/D)

Amerigroup (Wellpoint)

Anthem Blue Shield

Blue Cross Blue Shield

Carelon

Centene Corporation

Community Plan

Compsych

EmblemHealth

Fidelis

Medicaid

Medicare

Medicare Fee-for-Service (CMS)

Megellan

MultiPlan

Oscar

Oxford Health Plans

WellCare

Credentialing vs Enrollment

How to Get on Insurance Panels

Credentialing Resource Hub

Payer Enrollment Guides

Every month un-credentialed is revenue you never bill

Ask CredBrain

Get a Free Credentialing Consultation

You're all set!