How to become a Medicaid provider in Delaware
To bill Delaware Medicaid, enroll through DMAP Provider Portal — Provider Enrollment, run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- DMAP Provider Portal — Provider Enrollment
- Steps
- 6
- Documents
- 7
- Plans listed
- 3
On this page
Delaware Medicaid enrollment at a glance
To bill Delaware Medicaid, enroll through DMAP Provider Portal — Provider Enrollment, run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
- Program
- Delaware Medical Assistance Program (DMAP) / Diamond State Health Plan
- Enrollment portal
- DMAP Provider Portal — Provider Enrollment
- Fiscal agent
- Gainwell Technologies (DMAP provider portal and Provider Relations/enrollment help desk)
- Application fee
- DMAP states that from January 1, 2026, institutional providers pay $750 at initial application, reactivation, revalidation, re-enrollment and when adding a location. Its screening-level lists mark which taxonomies owe the fee; hardship exceptions go to CMS. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
- Fingerprinting
- DMAP publishes taxonomy screening-level lists (limited/moderate/high) for fee-for-service and managed-care-only providers; the high-risk taxonomies on those lists are subject to fingerprinting. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.
- Site visit
- Risk levels for site-visit purposes follow DMAP's published taxonomy screening-level lists. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.
- Revalidation
- DMAP mails revalidation instructions 60 days before the due date and terminates providers who miss it; it warns that CMS is requiring many providers to revalidate within the next 24 months. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Look up the taxonomy's screening level and fee status on DMAP's screening-level list
- For taxonomies that need it, get the authorization/qualification letter from DDDS, DSAMH or DSCYF first
- Complete the new Fee-for-Service application (or the Managed Care Organization-Only Provider application) in the DMAP Provider Portal
- Upload licenses and other attachments and pay the fee on the Attachments and Fees panel; print the cover sheet for any later documents
- Complete risk-based screening (site visit/fingerprints if moderate/high)
- To join plan networks, contract and credential separately with each MCO
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Most Delaware Medicaid members are in the Diamond State Health Plan through an MCO. Providers that serve only managed care members must still file a Managed Care Organization-Only Provider (MCOP) application in the DMAP portal; DMAP says this collects the information MCOs need for credentialing but does not guarantee a contract. Each MCO credentials and contracts separately, and DMMA requires all MCOs to hold NCQA accreditation. Centralized credentialing: no (shared state screening/enrollment, plan-by-plan credentialing).
- Plans (state list)
- AmeriHealth Caritas Delaware
- Delaware First Health
- Highmark Health Options
Frequently asked questions
How do I become a Medicaid provider in Delaware?
To bill Delaware Medicaid, enroll through DMAP Provider Portal — Provider Enrollment, run by Gainwell Technologies. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Delaware Medicaid?
DMAP states that from January 1, 2026, institutional providers pay $750 at initial application, reactivation, revalidation, re-enrollment and when adding a location. Its screening-level lists mark which taxonomies owe the fee; hardship exceptions go to CMS. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.
How often must Delaware Medicaid providers revalidate?
DMAP mails revalidation instructions 60 days before the due date and terminates providers who miss it; it warns that CMS is requiring many providers to revalidate within the next 24 months. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.