State Guide
Credentialing in Tennessee
Enrollment guides for 53 payers operating in Tennessee.
What actually differs in Tennessee
Credentialing advice written for "most states" tends to be wrong here in specific, expensive ways. These are the rules that only apply in Tennessee.
Compare Tennessee's credentialing deadline with every other state
- Behavioral health carved IN to the MCOs
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Tennessee integrates medical, behavioral and long-term care into its at-risk MCOs, Wellpoint (formerly Amerigroup), BlueCare (BCBS of Tennessee), and UnitedHealthcare Community Plan, plus TennCare Select for special populations such as foster care. There is no separate behavioral vendor: a BH clinician must credential and contract with each MCO directly, and one signed MCO is not TennCare-wide coverage.
TennCare Managed Care Contractors via kb/states/tn.md · checked Jul 2026
- TennCare registration (screen first)
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TennCare is 100% managed care, there is no meaningful fee-for-service track for routine providers. Everyone registers first through PDMS (TennCare's Provider Data Management System) to obtain a TennCare/Medicaid ID, individual providers route through CAQH, and only then contracts with each MCO. Skipping PDMS is Tennessee's classic mistake: without the Medicaid ID, claims deny across the board.
TennCare Provider Registration via kb/states/tn.md · checked Jul 2026
- Commercial credentialing decision deadline Tenn. Code § 56-7-1001
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Tenn. Code § 56-7-1001 requires a commercial health insurance entity to notify a provider of the result of a clean CAQH credentialing application, and whether it will contract, within 90 calendar days. It is a decision-deadline law, not a pay-while-pending law: it does not authorize in-network billing before the decision, and the statute does not establish that it reaches the TennCare Medicaid MCOs.
Tenn. Code § 56-7-1001 via kb/states/tn.md · checked Jul 2026
- Pre-licensed behavioral health billing TennCare Policy PRO 22-002
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Under TennCare Policy PRO 22-002, an unlicensed or pre-licensed master's-level therapist may render behavioral health services only under the supervision of a licensed professional, with the supervisor or agency billing. The pre-licensee does not bill under their own NPI. Requirements: a master's or doctoral BH degree, employment by a TennCare-contracted clinic or agency, a qualified licensed supervisor, and an application filed for a preliminary or provisional license with the relevant TN board.
TennCare PRO 22-002 via kb/states/tn.md · checked Jul 2026
- Behavioral health licensing boards
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LPCs and LMFTs license through the TN Board for Professional Counselors, Marital & Family Therapists, and Clinical Pastoral Therapists. The independent-practice counselor credential is the LPC/MHSP (Mental Health Service Provider designation). LCSWs license through the TN Board of Social Worker Licensure.
TN Dept of Health, counselor board, via kb/states/tn.md · checked Jul 2026
Want Tennessee handled for you?
A credentialing manager files the applications, chases the payers and tracks your recredentialing dates.
Get started freeWho Runs Tennessee Medicaid Provider Enrollment
50-state researchEnrollment Portal
TennCare Provider Data Management System
Operated By
Gainwell Technologies
Platform
PDMS
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)
Timeline: 90-150 days
CAQH Required
UnitedHealthcare
UnitedHealthcare
Timeline: 45-90 days
CAQH Required
Cigna Healthcare
Cigna Healthcare
Timeline: 45-60 days
CAQH Required
Anthem / Elevance Health
Anthem (Elevance Health)
Timeline: 45-90 days
CAQH Required
Humana
Humana
Timeline: 45-90 days
CAQH Required
Centene Corporation
Centene
Timeline: 60-90 days
CAQH Required
Molina Healthcare
Molina Healthcare
Timeline: 60-90 days
CAQH Required
BlueCross BlueShield of Tennessee
Timeline: 60-120 days
CAQH Required
TennCare
Timeline: 30-60 days
UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
Timeline: 30-60 days
CAQH Required
Amerigroup (Anthem)
Amerigroup Tennessee
Timeline: 30-60 days
CAQH Required
TRICARE
Timeline: 30-90 days
TRICARE East Region (Humana Military)
Timeline: 30-60 days
CAQH Required
CHAMPVA
CHAMPVA (VA Office of Integrated Veteran Care)
Timeline: 14-45 days
Delta Dental
Delta Dental
Timeline: 90-120 days
Cigna Dental
Cigna Dental
Timeline: 45-90 days
CAQH Required
MetLife Dental
MetLife Dental
Timeline: 60-120 days
Guardian Dental
Guardian Dental
Timeline: 60-90 days
Aetna Dental
Aetna Dental
Timeline: 60-120 days
CAQH Required
United Concordia
United Concordia Dental
Timeline: 45-90 days
CAQH Required
DentaQuest
DentaQuest (a Sun Life company)
Timeline: 30-60 days
MCNA Dental
MCNA Dental
Timeline: 30-60 days
Liberty Dental Plan
LIBERTY Dental Plan
Timeline: 10-90 days
Dental Network of America
Timeline: 60-90 days
VSP Vision Care
VSP Vision Care
Timeline: 30-60 days
EyeMed Vision Care
EyeMed Vision Care
Timeline: 30-60 days
Davis Vision
Davis Vision (Versant Health / MetLife)
Timeline: 30-60 days
Spectera / UHC Vision
Spectera (UnitedHealthcare Vision)
Timeline: 30-60 days
Optum Behavioral Health
Optum Behavioral Health (United Behavioral Health)
Timeline: 30-45 days
CAQH Required
Carelon Behavioral Health
Carelon Behavioral Health (formerly Beacon Health Options)
Timeline: 30-60 days
CAQH Required
Magellan Health
Magellan Behavioral Health
Timeline: 30-60 days
CAQH Required
Evernorth Behavioral Health
Evernorth Behavioral Health (formerly Cigna Behavioral Health)
Timeline: 30-60 days
CAQH Required
Oscar Health
Timeline: 45-90 days
CAQH Required
Clover Health
Timeline: 45-60 days
CAQH Required
Bright Health
Timeline: 45-90 days
CAQH Required
Workers' Compensation
Timeline: 14-60 days
Palmetto GBA (Jurisdiction J/M)
Timeline: 60-90 days
CGS Administrators (DME B/C)
Timeline: 60-120 days
Ambetter
Ambetter (a Centene company)
Timeline: 60-90 days
CAQH Required
Amerigroup (Wellpoint)
Timeline: 60-90 days
CAQH Required
Anthem Blue Shield
Timeline: 60-90 days
CAQH Required
Blue Cross Blue Shield
Timeline: 60-90 days
CAQH Required
Carelon
Timeline: 60-90 days
CAQH Required
Centene Corporation
Wellcare (a Centene company)
Timeline: 60-90 days
CAQH Required
Community Plan
Timeline: 60-90 days
CAQH Required
Compsych
Timeline: 60-90 days
CAQH Required
Medicaid
Timeline: 60-90 days
CAQH Required
Medicare
Timeline: 60-90 days
CAQH Required
Medicare Fee-for-Service (CMS)
Timeline: 45-120 days
Megellan
Magellan Behavioral Health
Timeline: 60-90 days
CAQH Required
MultiPlan
MultiPlan / Claritev (PHCS Network)
Timeline: 60-90 days
CAQH Required
Oscar
Timeline: 60-90 days
CAQH Required
WellCare
Timeline: 60-90 days
CAQH Required
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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