> ## Documentation Index
> Fetch the complete documentation index at: https://www.practiceownersguide.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Medicaid enrollment

> Enroll in Medicaid and its managed-care plans: one application per state, plus separate MCO credentialing.

Medicaid is the most commonly forgotten enrollment. It is state-run, so there
is one application per state, in that state's own system, on that state's own
timeline (30-120+ days). Nothing carries over from Medicare or CAQH.

## The two layers

Most states run Medicaid two ways at once, and you usually need both:

| Layer               | What it is                        | What you do                                                                                    |
| ------------------- | --------------------------------- | ---------------------------------------------------------------------------------------------- |
| Fee-for-service     | The state pays you directly       | Enroll in the state's provider enrollment system (e.g. TMHP PEMS in Texas, PAVE in California) |
| Managed care (MCOs) | Private plans administer Medicaid | Credential and contract with each MCO separately, like any commercial payer                    |

The state enrollment is a prerequisite: MCOs verify your state Medicaid ID
before contracting. Many MCOs in the [payer directory](/reference/payers) are
Medicaid plans (Wellpoint, Healthy Blue, Amerigroup).

## What the state application wants

The same file as [CAQH](/guides/caqh-setup) plus state extras: entity
documents, ownership disclosure (5%+ owners, which matters in
[MSO/PC structures](/guides/own-a-practice-without-a-license), disclose the PC
ownership accurately), a site visit for some provider types, and fingerprints
or background checks in higher-risk categories.

## EFT

Most states handle EFT inside the enrollment (Texas example:
[TMHP PEMS](/reference/payers/tmhp-texas-medicaid)). MCOs handle EFT through
their portals like any commercial payer.

## Keep it alive

States require periodic revalidation (commonly every 5 years, some more
often) and deactivate billing if you miss it. Add it to the
[compliance calendar](/guides/compliance-calendar). And bill within the
state's timely-filing window, which is often shorter than commercial payers'.

## Related

* [Get credentialed](/guides/get-credentialed)
* [Medicare enrollment via PECOS](/guides/medicare-pecos-enrollment)
* [CAQH from zero](/guides/caqh-setup)
* [Expand out of state](/guides/expand-out-of-state)