Moving Your Practice to Pennsylvania: 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 Pennsylvania touches every enrollment you have. The license, NPI record, Medicare enrollment, Pennsylvania Medical Assistance, each commercial plan, your CAQH (DataSpring) profile, your DEA registration and your malpractice policy all have to show Pennsylvania before claims there pay. Here is the order that works, with the Pennsylvania specifics.
The Checklist, Step by Step
- Get the Pennsylvania license. Physicians apply to the Pennsylvania State Board of Medicine (MDs) and State Board of Osteopathic Medicine (DOs). Nurses and nurse practitioners apply to the Pennsylvania State Board of Nursing. Every later step needs the license number, so start here. Pennsylvania 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 Pennsylvania license. Pennsylvania is in the Nurse Licensure Compact. A nurse who moves their primary residence to another compact state applies for a license in the new home state. Nurse practitioner authority is licensed separately by the Pennsylvania State Board of Nursing. Pennsylvania 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 Pennsylvania license. Pennsylvania is a Counseling Compact member. Privileges to practice under that compact are only starting to be issued, so counselors should plan on a Pennsylvania license for now.
- Register with DEA for Pennsylvania. 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 Pennsylvania; if you will practice in both states, get a separate Pennsylvania registration.
- Cover Pennsylvania on your malpractice policy. Many policies are written for specific states. Ask your carrier to add Pennsylvania 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 Pennsylvania location to your NPI record. Your NPI does not change. Log in to NPPES and add the Pennsylvania 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 Pennsylvania practice location, the Pennsylvania license, the new DEA registration and the malpractice certificate that covers Pennsylvania, then re-attest. Every commercial plan reads this profile, so do it before any commercial application goes out.
- Update Medicare in PECOS. Medicare in Pennsylvania is handled by Novitas Solutions, jurisdiction JL. If your current enrollment is with a different contractor, file a new CMS-855I with Novitas Solutions; the 855I covers only practice locations inside one contractor's jurisdiction. If Novitas Solutions already has your enrollment, add the Pennsylvania 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 Pennsylvania Medical Assistance. Pennsylvania Medical Assistance is run by the Pennsylvania Department of Human Services, and enrollment is filed through PROMISe. Medicaid enrollment does not transfer between states, so a new state means a new enrollment. Most Pennsylvania 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: Pennsylvania Medical Assistance managed care plans.
- Get credentialed with Independence Blue Cross and the other commercial plans. Blue plans in Pennsylvania: Independence Blue Cross, Highmark Blue Cross Blue Shield and Capital Blue Cross. Blue plans are separate companies licensed state by state, so a Blue contract in your old state does not cover Pennsylvania; apply as a new provider. National plans such as Aetna, Cigna, UnitedHealthcare and Humana need the Pennsylvania location added and credentialed before they pay claims there. How to join: Independence Blue Cross; Highmark Blue Cross Blue Shield; Capital Blue Cross.
What PECS Charges for a Move to Pennsylvania
| Service | Price | Billing |
|---|---|---|
| Medicare enrollment or new location, with reassignment | $500 per provider | 50% at engagement, 50% at submission |
| Pennsylvania Medical Assistance enrollment | $500 per provider per state | 50% at engagement, 50% at submission |
| Each commercial plan, including Independence Blue Cross | $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 Pennsylvania | $500 one time | At engagement |
Example: one provider moving to Pennsylvania with Medicare, Pennsylvania Medical Assistance, 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 Pennsylvania
How long does it take to move my credentialing to Pennsylvania?
The Pennsylvania license comes first, and its timing is set by the board. After that, Medicare through Novitas Solutions typically takes 45 to 90 days and Pennsylvania Medical Assistance typically 60 to 120 days. Commercial plans typically take 90 to 120 days. Run Medicare, Pennsylvania Medical Assistance and the commercial applications in parallel once the license, NPI record and CAQH (DataSpring) profile show the Pennsylvania address.
Do I need a new NPI when I move to Pennsylvania?
No. Your NPI stays the same for life. Add the Pennsylvania 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 Pennsylvania?
It depends on your current contractor. Pennsylvania is served by Novitas Solutions, jurisdiction JL. If your current enrollment is with a different contractor, you file a new CMS-855I with Novitas Solutions in PECOS, plus a reassignment if you bill through a group. If Novitas Solutions already handles your enrollment, you add the Pennsylvania 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 Pennsylvania?
Pennsylvania participates in the Interstate Medical Licensure Compact, the Nurse Licensure Compact, PSYPACT and 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 Pennsylvania?
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 Pennsylvania; if you will practice in both states, you need a Pennsylvania registration as well.
What does PECS charge to move my credentialing to Pennsylvania?
Medicare enrollment or new location $500 per provider, Pennsylvania Medical Assistance 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, Pennsylvania Medical Assistance, 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
- Pennsylvania State Board of Medicine (MDs) and State Board of Osteopathic Medicine (DOs)
- 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.