Moving Your Practice to Illinois: Credentialing Checklist
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
- Flat PricesNo percentage of collections
- Half Now, Half at SubmissionFor every enrollment application
- Closed Network?Your choice of a refund or a credit
- Live Status TrackingCheck any application by reference number
A move to Illinois touches every enrollment you have. The license, NPI record, Medicare enrollment, Illinois Medicaid (HFS), each commercial plan, your CAQH (DataSpring) profile, your DEA registration and your malpractice policy all have to show Illinois before claims there pay. Here is the order that works, with the Illinois specifics.
The Checklist, Step by Step
- Get the Illinois license. Physicians apply to the Illinois Department of Financial and Professional Regulation (IDFPR). Nurses and nurse practitioners apply to the Illinois Department of Financial and Professional Regulation (IDFPR), Board of Nursing. Every later step needs the license number, so start here. Illinois is a member of the Interstate Medical Licensure Compact. If your current full license is in another member state that can serve as your state of principal license, the compact offers an expedited path to the Illinois license. Illinois is a PSYPACT state. PSYPACT covers telepsychology and short temporary in-person work, not a permanent move, so a psychologist who relocates still needs a Illinois license.
- Register with DEA for Illinois. DEA registrations are state-specific: you need a registration in each state where you handle controlled substances, and the state license comes first. If you are leaving your old state, change the address on your current registration to Illinois; if you will practice in both states, get a separate Illinois registration. Illinois also requires a Illinois controlled substance license from the Illinois Department of Financial and Professional Regulation (IDFPR). IDFPR issues a separate controlled substance license for physicians, APRNs, physician assistants and other prescribers.
- Cover Illinois on your malpractice policy. Many policies are written for specific states. Ask your carrier to add Illinois or write a new policy before your first patient there, and settle tail or prior-acts coverage if you are leaving your current carrier.
- Add the Illinois location to your NPI record. Your NPI does not change. Log in to NPPES and add the Illinois practice location within 30 days of the change. If you still practice in your old state, keep that location too; an NPI record can list more than one practice location. Payers check applications against this record, so update it before you apply.
- Update and re-attest your CAQH (DataSpring) profile. Add the Illinois practice location, the Illinois license, the new DEA registration, the Illinois controlled substance license and the malpractice certificate that covers Illinois, then re-attest. Every commercial plan reads this profile, so do it before any commercial application goes out.
- Update Medicare in PECOS. Medicare in Illinois is handled by National Government Services, jurisdiction J6. If your current enrollment is with a different contractor, file a new CMS-855I with National Government Services; the 855I covers only practice locations inside one contractor's jurisdiction. If National Government Services already has your enrollment, add the Illinois location to it. If you will bill through a group, file the reassignment to that group at the same time. The effective date is the later of the filing date or the date you began seeing patients at the new location (42 CFR 424.520(d)), and you can bill up to 30 days before it when circumstances kept you from enrolling earlier (42 CFR 424.521(a)). File as soon as you have the license and the address.
- Enroll in Illinois Medicaid (HFS). Illinois Medicaid (HFS) is run by the Illinois Department of Healthcare and Family Services, and enrollment is filed through IMPACT, the Illinois Medicaid Program Advanced Cloud Technology system. Medicaid enrollment does not transfer between states, so a new state means a new enrollment. Most Illinois Medicaid members are in managed care plans, and each plan credentials you separately once the state enrollment is active. The plans and how to join each one: Illinois Medicaid (HFS) managed care plans.
- Get credentialed with Blue Cross and Blue Shield of Illinois and the other commercial plans. Blue plans in Illinois: Blue Cross and Blue Shield of Illinois. Blue plans are separate companies licensed state by state, so a Blue contract in your old state does not cover Illinois; apply as a new provider. National plans such as Aetna, Cigna, UnitedHealthcare and Humana need the Illinois location added and credentialed before they pay claims there. Illinois law gives commercial plans 60 days to make a credentialing decision, counted from submission of all credentials data and completion of verification; for mental health and substance use providers, plans issued or renewed from January 1, 2027 must also finish verification and contracting within 60 days of a complete application (410 ILCS 517/15(f); 215 ILCS 5/370c.4). How to join: Blue Cross and Blue Shield of Illinois.
While you wait in Illinois: Mental health and substance use providers (from 2027): once contracted, paid at the contract rate back to the date the complete application was submitted.
What PECS Charges for a Move to Illinois
| Service | Price | Billing |
|---|---|---|
| Medicare enrollment or new location, with reassignment | $500 per provider | 50% at engagement, 50% at submission |
| Illinois Medicaid (HFS) enrollment | $500 per provider per state | 50% at engagement, 50% at submission |
| Each commercial plan, including Blue Cross and Blue Shield of Illinois | $200 per plan per provider | 50% at engagement, 50% at submission |
| CAQH (DataSpring) update and re-attestation | $250 per provider | At engagement |
| NPI record update | $100 | At engagement |
| Group onboarding, for a new group in Illinois | $500 one time | At engagement |
Example: one provider moving to Illinois with Medicare, Illinois Medicaid (HFS), the CAQH update, the NPI update and 3 commercial plans is $1,950. We follow up with every payer until each application is approved, and you can check status any time with your reference number.
Questions About Moving to Illinois
How long does it take to move my credentialing to Illinois?
The Illinois license comes first, and its timing is set by the board. After that, Medicare through National Government Services typically takes 45 to 90 days and Illinois Medicaid (HFS) typically 60 to 120 days. Illinois law gives commercial plans 60 days to make a credentialing decision, counted from submission of all credentials data and completion of verification; for mental health and substance use providers, plans issued or renewed from January 1, 2027 must also finish verification and contracting within 60 days of a complete application (410 ILCS 517/15(f); 215 ILCS 5/370c.4). Run Medicare, Illinois Medicaid (HFS) and the commercial applications in parallel once the license, NPI record and CAQH (DataSpring) profile show the Illinois address.
Do I need a new NPI when I move to Illinois?
No. Your NPI stays the same for life. Add the Illinois practice location to your record in NPPES within 30 days of the change (45 CFR 162.410(a)(4)). If you still practice in your old state, keep that location as well; an NPI record can list more than one practice location.
Do I need a new Medicare enrollment to practice in Illinois?
It depends on your current contractor. Illinois is served by National Government Services, jurisdiction J6. If your current enrollment is with a different contractor, you file a new CMS-855I with National Government Services in PECOS, plus a reassignment if you bill through a group. If National Government Services already handles your enrollment, you add the Illinois location instead. The effective date is the later of the filing date or the date you started at the new location (42 CFR 424.520(d)), and you can bill up to 30 days before it when circumstances kept you from enrolling earlier (42 CFR 424.521(a)).
Can I use a licensure compact to practice in Illinois?
Illinois participates in the Interstate Medical Licensure Compact and PSYPACT. It is not in the Nurse Licensure Compact or the Counseling Compact. The medical compact speeds up getting the license; it does not replace it, and payer enrollment still has to be done in the new state. PSYPACT covers telepsychology and short temporary practice, not a permanent move.
Do I need a new DEA registration for Illinois?
Yes. DEA requires a separate registration in each state where you handle controlled substances, and the state's licensing requirements have to be met first. If you are leaving your old state, you can change the address on your current registration to Illinois; if you will practice in both states, you need a Illinois registration as well. Illinois also requires a Illinois controlled substance license from the Illinois Department of Financial and Professional Regulation (IDFPR).
What does PECS charge to move my credentialing to Illinois?
Medicare enrollment or new location $500 per provider, Illinois Medicaid (HFS) enrollment $500 per provider, each commercial plan $200 per plan per provider, CAQH (DataSpring) update and re-attestation $250, NPI record update $100, and group onboarding $500 one time if you are setting up a new group. Enrollments are billed 50% at engagement and 50% at submission. One provider with Medicare, Illinois Medicaid (HFS), the CAQH update, the NPI update and 3 commercial plans is $1,950.
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Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Sources
- Illinois Department of Financial and Professional Regulation (IDFPR)
- Illinois controlled substance license
- CMS-855I Medicare enrollment application (practice locations in another MAC jurisdiction need a separate 855I)
- 42 CFR 424.520(d): effective date of billing privileges
- 42 CFR 424.521(a): billing up to 30 days before the effective date
- 45 CFR 162.410(a)(4): report NPI data changes within 30 days
- DEA Diversion Control: registration FAQ (separate registration in each state)
- Interstate Medical Licensure Compact member list (CSG)
- Nurse Licensure Compact (NCSBN)
- PSYPACT map
- Counseling Compact map
By the PECS credentialing team, updated October 20, 2026. Compact memberships and board names checked in October 2026; confirm with the board before you apply.