Medicare
Credentialing and enrollment guides for Medicare across 51 states.
Quick Overview
Timeline
60 - 90 days
CAQH
Required
Re-credentialing
Every 3 year(s)
States Available
51
About Medicare
Medicare is the federal health insurance program for people 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease. Medicare Part B covers outpatient services and requires provider enrollment through PECOS.
How to Get Credentialed
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and board certifications.
Complete Your CAQH ProView Profile
Medicare requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org.
Submit Your Application
Submit your completed enrollment package to Medicare. Select your state below for state-specific submission details.
Track & Follow Up
Credentialing typically takes 60-90 days. Monitor your application and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Medicare?
Our specialists handle the entire Medicare enrollment process: applications, follow-ups, and approvals across all 50 states.
Contact Information
Medicare Provider Enrollment (PECOS)
1-866-837-0241
Mon-Fri 8am-6pm ET
Medicare Provider Contact Center
1-855-798-2627
Mon-Fri 8am-6pm local time
Medicare EDI/EFT Support
1-866-837-0241
Quick Links
Available States
+ 36 more states below
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 Medicare-specific credentialing details including timelines, contacts, and local requirements.
Medicare credentialing requirements by state
Medicare enrollment is not identical everywhere. The table below lists what actually differs across the 51 states Medicare operates in — network status, local plan names, portals and the state-specific conditions our credentialing team has recorded.
| State | Local plan | Network | Timeline | Portal / phone | State-specific notes |
|---|---|---|---|---|---|
| Alaska | — | Open | — | — | — |
| Alabama | — | Open | — | — | — |
| Arkansas | — | Open | — | — | — |
| Arizona | — | Open | — | — | — |
| California | Medicare Part B — California (Noridian Healthcare Solutions, MAC J-E) | Open | 45–65 days |
Provider portal
1-866-837-0241
|
Medicare Part B enrollment in California is administered by Noridian Healthcare Solutions, the Medicare Administrative Contractor (MAC) for Jurisdiction E, which covers California, Nevada, Hawaii, American Samoa, Guam, and the Northern Mariana Islands. Providers enroll through PECOS using the appropriate CMS form: 855I for individual practitioners, 855B for clinics and group practices, 855R for reassignment of benefits to a group, or 855A for institutional providers. Standard PECOS processing is 45-65 days when the application is clean. California-specific items: Medical Board of California (or allied health board) license verification, retroactive billing limited to 30 days before the enrollment effective date per Medicare rules, and California Medicare Advantage plans (such as CalOptima in Orange County) require separate enrollment with each MA organization. Revalidation required every 5 years per the standard CMS revalidation schedule. |
| Colorado | — | Open | — | — | — |
| Connecticut | — | Open | — | — | — |
| District Of Columbia | — | Open | — | — | — |
| Delaware | — | Open | — | — | — |
| Florida | — | Open | — | — | — |
| Georgia | — | Open | — | — | — |
| Hawaii | — | Open | — | — | — |
| Iowa | — | Open | — | — | — |
| Idaho | — | Open | — | — | — |
| Illinois | — | Open | — | — | — |
| Indiana | — | Open | — | — | — |
| Kansas | — | Open | — | — | — |
| Kentucky | — | Open | — | — | — |
| Louisiana | — | Open | — | — | — |
| Massachusetts | — | Open | — | — | — |
| Maryland | — | Open | — | — | — |
| Maine | — | Open | — | — | — |
| Michigan | — | Open | — | — | — |
| Minnesota | — | Open | — | — | — |
| Missouri | — | Open | — | — | — |
| Mississippi | — | Open | — | — | — |
| Montana | — | Open | — | — | — |
| North Carolina | — | Open | — | — | — |
| North Dakota | — | Open | — | — | — |
| Nebraska | — | Open | — | — | — |
| New Hampshire | — | Open | — | — | — |
| New Jersey | — | Open | — | — | — |
| New Mexico | — | Open | — | — | — |
| Nevada | — | Open | — | — | — |
| New York | — | Open | — | — | — |
| Ohio | — | Open | — | — | — |
| Oklahoma | — | Open | — | — | — |
| Oregon | — | Open | — | — | — |
| Pennsylvania | — | Open | — | — | — |
| Rhode Island | — | Open | — | — | — |
| South Carolina | — | Open | — | — | — |
| South Dakota | — | Open | — | — | — |
| Tennessee | — | Open | — | — | — |
| Texas | — | Open | — | — | — |
| Utah | — | Open | — | — | — |
| Virginia | — | Open | — | — | — |
| Vermont | — | Open | — | — | — |
| Washington | — | Open | — | — | — |
| Wisconsin | — | Open | — | — | — |
| West Virginia | — | Open | — | — | — |
| Wyoming | — | Open | — | — | — |
Compiled and maintained by the PayerReady credentialing team from payer portals and direct payer contact. Last verified April 24, 2026. Network status changes without notice — confirm before you file.
Common questions about Medicare credentialing
How long does Medicare credentialing take?
Medicare credentialing typically takes 60–90 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 Medicare require CAQH?
Yes. Medicare pulls provider data from CAQH ProView, so your profile must be complete, attested and shared with Medicare before the application can move. CAQH re-attestation runs on a 120-day cycle, and a lapsed attestation stalls both new enrollments and recredentialing.
Which states does Medicare operate in?
Medicare has credentialing operations in 51 states. 51 of those 51 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.