State Guide

Credentialing in Washington

Enrollment guides for 54 payers operating in Washington.

What actually differs in Washington

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

3 sourced rules, each linked to its source

Who on your team can bill 3

3 sourced rules

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

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Associate ProviderOne registration mechanics

HCA's provider alert requires associates to be registered in ProviderOne under their own NPI and as a servicing provider under the facility or clinic with taxonomy 101Y00000X. Providers had until December 31, 2024 to complete registration before the own-NPI billing requirement took effect.

WA HCA provider alert 2024-05-08 via kb/states/wa.md · checked Jul 2026

Associates render under their OWN NPI (Part I claims) WAC 182-531-1400(5); RCW 18.225.145

Since July 1, 2024, Washington associates (LSWAIC, LASWA, LMFTA, LMHCA) are allowable provider types in the Apple Health Mental Health Billing Guide Part I: the associate registers in ProviderOne under their own NPI as a servicing provider under the facility or clinic (own-NPI requirement effective January 1, 2025), with associate-specific taxonomies from 2026. The billing provider remains the employing clinic/group, and associates cannot bill Medicare, dual-eligible claims carry the 'LMHP associate' claim note. Since October 1, 2025, master's-level associates may practice under a pending associate license for up to 120 days after a completed DOH application.

WA HCA Mental Health Services Billing Guide (eff. 2026-07-01) via kb/states/wa.md · checked Jul 2026

Part II carve-out (clinic NPI only)

The associate-renders pattern is a Part I rule only. Part II specialized mental health claims (agency/CMHC lane, including all three Apple Health coverage types for Tribes) are billed with the clinic NPI and taxonomy only, no individual, associate or fully licensed, appears as the servicing provider. Any Washington billing setup must be claim-lane-aware: Part I professional claims carry the associate’s servicing NPI, and Part II specialized claims carry the clinic NPI only.

WA HCA Mental Health Services Billing Guide, Part II, via kb/states/wa.md · checked Jul 2026

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Who Runs Washington Medicaid Provider Enrollment

50-state research

Enrollment Portal

ProviderOne

Operated By

Acentra Health (formerly CNSI)

Platform

ProviderOne

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)

Commercial

Network: Open

Timeline: 90-150 days

CAQH Required

Credentialing in Washington

What actually differs in Washington

Who Runs Washington Medicaid Provider Enrollment

Aetna

UnitedHealthcare

Cigna Healthcare

Anthem / Elevance Health

Humana

Centene Corporation

Molina Healthcare

Kaiser Permanente

Premera Blue Cross (Washington)

Regence BlueShield (Washington)

Apple Health

UnitedHealthcare Community Plan

Amerigroup (Anthem)

Molina Healthcare (Medicaid)

TRICARE

TRICARE West Region (TriWest Healthcare Alliance)

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

Workers' Compensation

Noridian Healthcare Solutions (Jurisdiction E)

Noridian Healthcare Solutions (DME A/D)

Ambetter

AmeriHealth Caritas

Amerigroup (Wellpoint)

Anthem Blue Shield

Blue Cross Blue Shield

Carelon

Centene Corporation

Community Plan

Compsych

Kaiser Permanente Health Plans

Medicaid

Medicare

Medicare Fee-for-Service (CMS)

Megellan

MultiPlan

WellCare

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