Nurse Practitioner Credentialing in Utah
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
| NP practice environment | Full Practice (AANP) |
|---|---|
| Licensing authority | The Utah board of nursing alone |
| Medicare contractor | Noridian Healthcare Solutions, jurisdiction JF |
| Medicaid | Utah Medicaid, enrolled through PRISM, the Utah Medicaid provider portal |
| Medicaid managed care | 4 plans, 260,258 members (2024) |
| Blue Cross Blue Shield plan | Regence BlueCross BlueShield of Utah |
Utah Is a Full Practice State
The American Association of Nurse Practitioners classifies Utah as full practice: state law lets nurse practitioners evaluate patients, diagnose, order and interpret tests, and prescribe under the exclusive licensure authority of the state board of nursing. 28 of the 50 states and DC have that classification.
For credentialing, full practice means the application is about you alone. Utah Medicaid and the commercial plans in Utah generally do not ask for a collaborating physician, so the fields that hold up NP files in other states are simply absent. Medicare's rule for NP services (42 CFR 410.75) defers to state law on collaboration, and where state law is silent it expects the NP to document their scope of practice and how they work with physicians on issues outside it. Enrollment itself runs through PECOS and Noridian Healthcare Solutions on the CMS-855I like any other independent practitioner.
What still slows Utah NPs down is the business side: an NP-owned entity needs its own Type 2 NPI, a group enrollment and a reassignment for each clinician, and some commercial plans review NP-owned practices more slowly than physician groups. If you are new to independent practice, confirm with the board whether any transition-to-practice hours apply to you before the applications go in, because payers will ask for the license status that results.
Utah Medicaid Managed-Care Plans for NPs
After the state enrollment, each managed-care plan credentials you as its own application. The largest in Utah by 2024 enrollment:
- Select Health: 104,458 members
- University of Utah Health Plans (Healthy U, HOME): 62,072 members
- Molina: 61,210 members
See all 4 plans.
Neighboring States
Every state bordering Utah is also full practice, so the agreement rules are similar across the line, though each state still needs its own license and payer enrollments.
- Arizona NP credentialing (Full Practice)
- Colorado NP credentialing (Full Practice)
- Idaho NP credentialing (Full Practice)
- New Mexico NP credentialing (Full Practice)
- Nevada NP credentialing (Full Practice)
- Wyoming NP credentialing (Full Practice)
The full NP checklist, the entity decision and where applications stall are in our nurse practitioner credentialing guide. For Medicare, Medicaid and commercial plans for every clinician type in the state, see credentialing in Utah.
Questions Utah NPs Ask
Do Utah nurse practitioners need a collaborating physician to get credentialed?
No. AANP classifies Utah as full practice, so payers generally do not require a collaborating physician on an NP application. Check with the board of nursing whether any transition-to-practice requirement applies to a newly licensed NP.
How does an Utah NP join Utah Medicaid?
Enroll with the Utah Department of Health and Human Services through PRISM, the Utah Medicaid provider portal. Most Utah Medicaid members are in managed care (260,258 enrolled across 4 plans in 2024), so after the state enrollment is active, each plan you want, such as Select Health, University of Utah Health Plans (Healthy U, HOME), Molina, credentials you separately.
Can an NP licensed in Utah see patients in a neighboring state?
Only with a license from that state, and each state's practice rules apply to the patients there. Arizona is full practice; Colorado is full practice; Idaho is full practice; New Mexico is full practice; Nevada is full practice; Wyoming is full practice. Payer enrollment is also per state, so seeing patients across the line means a separate Medicaid enrollment and separate commercial applications there.
What does PECS charge an Utah NP?
CAQH (DataSpring) profile build $500; Medicare enrollment $500; Utah Medicaid enrollment $500; each commercial application, including Regence BlueCross BlueShield of Utah, $200 per provider. Enrollment services bill 50% at engagement and 50% at submission.
Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources: American Association of Nurse Practitioners, State Practice Environment (updated May 2026); KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Practice classification is AANP's; confirm current rules with the Utah board of nursing. Updated October 7, 2026.