Moving your practice

Moving Your Practice to Virginia: Credentialing Checklist

A move to Virginia touches every enrollment you have. The license, NPI record, Medicare enrollment, Virginia Medicaid (Cardinal Care), each commercial plan, your CAQH (DataSpring) profile, your DEA registration and your malpractice policy all have to show Virginia before claims there pay. Here is the order that works, with the Virginia specifics.

The Checklist, Step by Step

1. Get the Virginia license. Physicians apply to the Virginia Board of Medicine. Nurses and nurse practitioners apply to the Virginia Board of Nursing. Every later step needs the license number, so start here. Virginia 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 Virginia Board of Nursing. Virginia 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 Virginia license. Virginia is a Counseling Compact member. Privileges to practice under that compact are only starting to be issued, so counselors should plan on a Virginia license for now.
2. Register with DEA for Virginia. 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 Virginia; if you will practice in both states, get a separate Virginia registration.
3. Cover Virginia on your malpractice policy. Many policies are written for specific states. Ask your carrier to add Virginia or write a new policy before your first patient there, and settle tail or prior-acts coverage if you are leaving your current carrier.
4. Add the Virginia location to your NPI record. Your NPI does not change. Log in to NPPES and add the Virginia 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.
5. Update and re-attest your CAQH (DataSpring) profile. Add the Virginia practice location, the Virginia license, the new DEA registration and the malpractice certificate that covers Virginia, then re-attest. Every commercial plan reads this profile, so do it before any commercial application goes out.
6. Update Medicare in PECOS. Medicare in Virginia is handled by Palmetto GBA, jurisdiction JM. If your current enrollment is with a different contractor, file a new CMS-855I with Palmetto GBA; the 855I covers only practice locations inside one contractor's jurisdiction. If Palmetto GBA already has your enrollment, add the Virginia 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.
7. Enroll in Virginia Medicaid (Cardinal Care). Virginia Medicaid (Cardinal Care) is run by the Virginia Department of Medical Assistance Services, and enrollment is filed through the Provider Services Solution (PRSS) portal. Medicaid enrollment does not transfer between states, so a new state means a new enrollment. Most Virginia 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: Virginia Medicaid (Cardinal Care) managed care plans.
8. Get credentialed with Anthem Blue Cross and Blue Shield and the other commercial plans. Blue plans in Virginia: Anthem Blue Cross and Blue Shield. Blue plans are separate companies licensed state by state, so a Blue contract in your old state does not cover Virginia; apply as a new provider. National plans such as Aetna, Cigna, UnitedHealthcare and Humana need the Virginia location added and credentialed before they pay claims there. Virginia law gives commercial plans 60 days to make a credentialing decision, counted from a completed application, deemed complete 30 days after receipt unless the plan says otherwise (Va. Code Ann. § 38.2-3407.10:1). How to join: Anthem Blue Cross and Blue Shield; CareFirst BlueCross BlueShield.

While you wait in Virginia: Once credentialed and contracted, services during the pending period are paid at the in-network rate.

What PECS Charges for a Move to Virginia

Example: one provider moving to Virginia with Medicare, Virginia Medicaid (Cardinal Care), 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 Virginia

Sources

• Virginia Board of Medicine
• 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.