How to become a Medicaid provider in Washington
To bill Washington Medicaid, enroll through ProviderOne. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- ProviderOne
- Steps
- 6
- Documents
- 6
- Plans listed
- 5
On this page
Washington Medicaid enrollment at a glance
To bill Washington Medicaid, enroll through ProviderOne. The process has 6 steps, listed below with the documents the state asks for.
- Program
- Washington Apple Health (Medicaid), Washington State Health Care Authority (HCA)
- Enrollment portal
- ProviderOne
- 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. HCA's enrollment and revalidation 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. HCA's enrollment and revalidation 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. HCA's enrollment and revalidation pages do not describe a separate state site visit process.
- Revalidation
- HCA revalidates providers every five years under 42 CFR 455 and mails one letter per group or facility to the ProviderOne mailing address. The provider has 30 days from the notice date. After that a deactivation notice is sent and the provider gets 90 more days before billing privileges are affected. Billing providers revalidate through ProviderOne's 'Manage Provider Information' Business Process Wizard. They update ownership, managing-employee and controlling-interest disclosures and submit the Core Provider Agreement, Debarment Statement, W-9 and type-specific documents. Nonbilling providers use the nonbilling forms and the HCA support portal or fax. HCA and DSHS are doing off-cycle revalidations of certain providers by June 5, 2028.
- Provider manual
- Provider manual
Steps
- Confirm you are an eligible provider type
- Pick the enrollment path: billing provider, health care professional under a group or facility, nonbilling provider (managed-care-only or ordering/referring/prescribing), or billing agent/clearinghouse
- Complete the supplemental paperwork for your provider type
- Fill out the ProviderOne application using HCA's enrollment manual for your type
- Billing providers sign the Core Provider Agreement and other required documents
- Follow HCA's next steps for new providers, and contract separately with Apple Health managed care plans
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Most Apple Health clients are in managed care, and each plan has its own provider network. Providers who only serve managed care or behavioral health organization clients enroll with HCA as nonbilling providers, then contract and credential with each plan. HCA's pages reviewed describe no centralized Medicaid credentialing. Dental, children's vision hardware, long-term care and some inpatient psychiatric physician services stay fee-for-service.
- Plans (state list)
- Community Health Plan of Washington (CHPW)
- Coordinated Care (CC)
- Molina Healthcare of Washington (MHW)
- UnitedHealthcare Community Plan (UHC)
- Wellpoint Washington (WLP)
Frequently asked questions
How do I become a Medicaid provider in Washington?
To bill Washington Medicaid, enroll through ProviderOne. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Washington 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. HCA's enrollment and revalidation pages do not list a separate state fee.
How often must Washington Medicaid providers revalidate?
HCA revalidates providers every five years under 42 CFR 455 and mails one letter per group or facility to the ProviderOne mailing address. The provider has 30 days from the notice date. After that a deactivation notice is sent and the provider gets 90 more days before billing privileges are affected. Billing providers revalidate through ProviderOne's 'Manage Provider Information' Business Process Wizard. They update ownership, managing-employee and controlling-interest disclosures and submit the Core Provider Agreement, Debarment Statement, W-9 and type-specific documents. Nonbilling providers use the nonbilling forms and the HCA support portal or fax. HCA and DSHS are doing off-cycle revalidations of certain providers by June 5, 2028.