How to become a Medicaid provider in Tennessee
To bill Tennessee Medicaid, enroll through TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers
- Steps
- 6
- Documents
- 4
- Plans listed
- 4
On this page
Tennessee Medicaid enrollment at a glance
To bill Tennessee Medicaid, enroll through TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers. The process has 6 steps, listed below with the documents the state asks for.
- Program
- TennCare (Division of TennCare, Tennessee)
- Enrollment portal
- TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers
- Application fee
- Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. TennCare's registration pages do not list a separate state fee.
- Fingerprinting
- Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. TennCare's registration pages do not describe a separate state fingerprint process.
- Site visit
- Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. TennCare's registration pages do not describe a separate state site visit process.
- Revalidation
- Every TennCare provider enrollment must be revalidated every 3 years, more often than the federal 5-year minimum. Submitting any update in the enrollment portal resets the due date. Groups and entities see the due date at the top of their enrollment. Individual providers revalidate by submitting their Data Spring (CAQH ProView) application.
- Provider manual
- Provider manual
Steps
- Get an NPI and watch TennCare's welcome video and road map for your provider category
- Groups, organizations and entities: file the Provider Enrollment Application, including the ownership section and required documents, in the registration portal, then check status with the login provided
- Individuals, step 1: enter basic information in the TennCare provider registration portal
- Individuals, step 2: complete or update a Data Spring (CAQH ProView) application, which TennCare requires; TennCare then pulls the profile data automatically
- Once linked to a group or organization, the individual receives a Medicaid ID by email
- With the Medicaid ID, contract separately with each TennCare MCO to join its network
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- TennCare services are delivered by at-risk MCOs. Each MCO writes its own provider contracts, keeps its own fee schedule and network, and pays its own claims. A provider needs an active TennCare Medicaid ID before any MCO will consider contracting, then contracts with each MCO separately. TennCare requires Data Spring (CAQH ProView) for individual registration, which removes duplicate data entry, but TennCare pages do not describe one shared credentialing decision across MCOs.
- Plans (state list)
- BlueCare Tennessee
- UnitedHealthcare Community Plan
- Wellpoint
- TennCare Select
Frequently asked questions
How do I become a Medicaid provider in Tennessee?
To bill Tennessee Medicaid, enroll through TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Tennessee Medicaid?
Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. TennCare's registration pages do not list a separate state fee.
How often must Tennessee Medicaid providers revalidate?
Every TennCare provider enrollment must be revalidated every 3 years, more often than the federal 5-year minimum. Submitting any update in the enrollment portal resets the due date. Groups and entities see the due date at the top of their enrollment. Individual providers revalidate by submitting their Data Spring (CAQH ProView) application.