Credentialing Timelines by State and Payer

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CAQH profile, newBuilt, documented and attested$500Medicare enrollmentPECOS enrollment or reassignment$500Commercial plansAetna, Blue Cross, Cigna, UnitedHealthcare and others$200/plan

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Commercial plans

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Medicare enrollment$500

Commercial plans × 3$600

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How long payers are allowed, or say they take, to credential a provider. This page collects 72 cited rules: Medicare processing targets set by CMS, NCQA accreditation standards, statements from the payers themselves, state credentialing laws for commercial plans, and Medicaid program and managed care contract terms. Every row links to its source.

Read these as limits, not averages. A legal deadline or a CMS target says how long a payer may take once the application is complete, not how long applications actually take. Only rows labeled Measured Result report observed performance. Nearly every clock starts from a complete application, so a missing document or an unanswered request restarts or pauses it.

National Rules and Targets

Medicare (CMS Processing Targets)

CMS sets these timeframes for its Medicare Administrative Contractors (MACs). Where a row gives two numbers, the first is the share of applications CMS expects done by that day (95% of initial applications, 80% of revalidations) and the second is the day by which all should be done. The clock stops while fingerprints or a development request are pending.

Payer	Rule or target	Days	Type	Source
Medicare Medicare	Paper CMS-855: 60-day processing time in most cases MAC plain-language summary; paper versus internet-based PECOS.	60 days	CMS Target	CGS Medicare (J15 Part B MAC): Enrollment Application As of October 2026
Medicare Medicare	Internet-based PECOS: 45-day processing time in most cases MAC plain-language summary; the CMS-defined percentile targets are in the cms-855-* rows.	45 days	CMS Target	CGS Medicare (J15 Part B MAC): Enrollment Application As of October 2026
Medicare Medicare	Paper CMS-855 initial enrollment or change of information, site visit, development and/or fingerprinting: 95% completed within 65 calendar days of receipt, 100% within 100 min_days = the 95% threshold, max_days = the 100% threshold. Clock stops while fingerprint results or a dependent application development request are pending. Opt-out affidavits share the paper initial standard.	65 to 100 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Paper CMS-855 initial enrollment or change of information, no site visit, development or fingerprinting: 95% completed within 30 calendar days of receipt, 100% within 65 min_days = the 95% threshold, max_days = the 100% threshold. Clock stops while fingerprint results or a dependent application development request are pending. Opt-out affidavits share the paper initial standard.	30 to 65 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Paper CMS-855 revalidation, site visit, development and/or fingerprinting: 80% completed within 65 calendar days of receipt, 100% within 100 min_days = the 80% threshold, max_days = the 100% threshold. Clock stops for fingerprints and development as for initial applications.	65 to 100 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Paper CMS-855 revalidation, no site visit, development or fingerprinting: 80% completed within 30 calendar days of receipt, 100% within 65 min_days = the 80% threshold, max_days = the 100% threshold. Clock stops for fingerprints and development as for initial applications.	30 to 65 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Internet-based PECOS initial enrollment or change of information, site visit, development and/or fingerprinting: 95% completed within 50 calendar days of receipt, 100% within 85 min_days = the 95% threshold, max_days = the 100% threshold. Clock stops while fingerprint results or a dependent application development request are pending.	50 to 85 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Internet-based PECOS initial enrollment or change of information, no site visit, development or fingerprinting: 95% completed within 15 calendar days of receipt, 100% within 50 min_days = the 95% threshold, max_days = the 100% threshold. Clock stops while fingerprint results or a dependent application development request are pending.	15 to 50 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Internet-based PECOS revalidation, site visit, development and/or fingerprinting: 80% completed within 50 calendar days of receipt, 100% within 85 min_days = the 80% threshold, max_days = the 100% threshold. Clock stops for fingerprints and development as for initial applications.	50 to 85 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Internet-based PECOS revalidation, no site visit, development or fingerprinting: 80% completed within 15 calendar days of receipt, 100% within 50 min_days = the 80% threshold, max_days = the 100% threshold. Clock stops for fingerprints and development as for initial applications.	15 to 50 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026
Medicare Medicare	Part A certified providers: CMS may take an additional 6 to 9 months for the final determination, on top of the MAC processing timeframe Source states 6-9 months; days are that range converted (6 x 30, 9 x 30). Applies to certified providers (855A), not individual practitioners.	180 to 270 days	CMS Target	First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined) As of February 2026

Commercial Payers (Published by the Payer)

What each payer says on its own provider pages. These are the payer's statements, not independently measured.

Payer	Rule or target	Days	Type	Source
Elevance Health (Anthem) Commercial	Credentialing typically takes 45 days from receipt of the completed CAQH application	45 days	Payer Published	Anthem: Provider credentialing As of October 2026
Cigna Commercial	Credentialing typically takes 45 to 60 days from receipt of the application packet Directory and claim-system upload typically within 10 business days after approval.	45 to 60 days	Payer Published	Cigna Healthcare: Join Our Network (health care professionals) As of October 2026
UnitedHealthcare Commercial	Contract loaded into UHC systems up to 60 days after credentialing approval and receipt of the signed contract Runs after the credentialing window.	60 days	Payer Published	UnitedHealthcare: Join Our Network, Medical Provider As of October 2026
UnitedHealthcare Commercial	Credentialing takes up to 45 calendar days or more once UHC has a completed application and all required information Same page: contract may be mailed within 5 business days of a credentialing request; timing also depends on schools, boards and hospitals responding.	45 days	Payer Published	UnitedHealthcare: Join Our Network, Medical Provider As of October 2026

Accreditation Standards (NCQA)

NCQA standards bind accredited plans. They limit how old verifications can be and how fast a decision must be sent, not the total turnaround.

Payer	Rule or target	Days	Type	Source
NCQA-accredited plans All payer types	Practitioner notified of the credentialing or recredentialing decision within 30 calendar days of the decision Shortened from 60 to 30 calendar days under the 2025 NCQA standards, effective July 1, 2025.	30 days	Accreditation Standard	Blue Cross and Blue Shield of Vermont: Notice of quality policy changes (May 2025), aligning to 2025 NCQA Health Plan standards As of July 2025
NCQA-accredited plans All payer types	Verification time limit: primary source verifications no older than 120 calendar days at the credentialing decision Reduced from 180 to 120 days under the 2025 NCQA Health Plan Accreditation standards, effective July 1, 2025. Bounds verification age, not total turnaround: verifications older than 120 days at committee must be redone. NCQA Credentialing Accreditation/Certification (CVO, delegate) programs keep their own table: https://wpcdn.ncqa.org/www-prod/NCQA-Credentialing-eBook-2025.pdf	120 days	Accreditation Standard	Blue Cross and Blue Shield of Vermont: Notice of quality policy changes (May 2025), aligning to 2025 NCQA Health Plan standards As of July 2025

State Deadlines at a Glance

The longest and shortest day counts we found for each state, by payer type. Select a state for the full rule, any conditions and the source.

State	Commercial (state law)	Medicaid fee for service	Medicaid managed care
Arizona	60 days State Law	None listed	14 to 60 days Medicaid Contract
Arkansas	60 to 180 days State Law	None listed	None listed
California	60 to 90 days State Law	90 to 180 days State Law	None listed
Colorado	60 days State Law	None listed	90 days Medicaid Contract
Delaware	45 days State Law	None listed	None listed
Florida	None listed	None listed	60 days Medicaid Contract
Georgia	90 days State Law	None listed	45 days Medicaid Contract
Idaho	None listed	None listed	120 days Medicaid Contract
Illinois	60 days State Law	None listed	None listed
Indiana	None listed	None listed	30 days Medicaid Contract
Iowa	56 days State Law	None listed	None listed
Kansas	None listed	None listed	45 days Medicaid Contract
Kentucky	45 days State Law	None listed	30 days Medicaid Contract
Louisiana	90 days State Law	None listed	60 days Medicaid Contract
Maine	60 days State Law	None listed	None listed
Maryland	150 days State Law	None listed	None listed
Massachusetts	60 days State Law	None listed	None listed
Minnesota	45 days State Law	None listed	None listed
Missouri	84 days State Law	None listed	None listed
New Hampshire	30 to 45 days State Law	None listed	30 days Medicaid Contract
New Jersey	90 days State Law	None listed	90 days Medicaid Contract
New Mexico	30 days State Law	None listed	None listed
New York	60 days State Law	120 days State Law	None listed
North Carolina	60 days State Law	None listed	None listed
Ohio	90 days State Law	None listed	None listed
Oregon	90 days State Law	None listed	None listed
Rhode Island	45 days State Law	None listed	None listed
Tennessee	90 days State Law	None listed	None listed
Texas	90 days State Law	84 days Payer Published	90 days Medicaid Contract
Vermont	60 days State Law	None listed	None listed
Virginia	60 to 120 days State Law	None listed	None listed
Washington	90 days State Law	None listed	None listed
West Virginia	120 days State Law	None listed	None listed
Wyoming	60 days State Law	None listed	None listed

None listed means this dataset has no row for that payer type in that state, not that no rule exists. For every state's credentialing statute, including states with no deadline, see credentialing laws by state.

State Detail

Arizona

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Credentialing concluded within 60 calendar days of a complete application Effective April 1, 2026 (previously 100 days). Receipt and completeness notice within 7 days; loaded for billing within 30 days of approval. Interim: once contracted, services paid back to the date on the complete-application notice if patients were told in writing (A.R.S. 20-3456). Cross-checked with UHC addendum.	60 days	State Law	A.R.S. 20-3453, 20-3454 (SB 1291, 2025) As of October 2026
AHCCCS contractors (Medicaid MCOs) Medicaid MCO	Temporary/provisional credentialing decision within 14 calendar days of receipt of a complete application (100%) Provisional providers loaded within 14 calendar days of approval (95%) so they can be paid.	14 days	Medicaid Contract	AHCCCS Medical Policy Manual, Policy 950, sec. III.B.2 and J As of October 2026
AHCCCS contractors (Medicaid MCOs) Medicaid MCO	Initial credentialing decision within 60 days of receipt of a completed application (100%) Policy 950 effective 10/01/26. Loading into claims within 30 calendar days of committee approval (95%).	60 days	Medicaid Contract	AHCCCS Medical Policy Manual, Policy 950 (Credentialing and Recredentialing), sec. III.C.7 and J As of October 2026

Credentialing in Arizona

Arkansas

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Physicians: decision within 60 days of a completed application (tolled while the state CCVS works the file) Approved physician treated as participating from the date the completed application was submitted. $1,000 per day fine past the deadline. Cross-checked with UHC addendum.	60 days	State Law	Ark. Code Ann. 23-99-411 As of October 2026
All commercial (state law) Commercial	Non-physician providers: decision within 180 days of a completed application Cross-checked with UHC addendum.	180 days	State Law	Ark. Code Ann. 23-99-411 As of October 2026

Credentialing in Arkansas

California

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Behavioral health (delegated capitated groups): assessment within 60 days of a completed application Effective January 1, 2023; receipt and completeness notice within 7 days. Statute text not independently re-fetched; cited via the UHC addendum.	60 days	State Law	Cal. Health & Safety Code 1374.197, as summarized in the UHC addendum As of September 2026
All commercial (state law) Commercial	Credentialing decision within 90 days of a complete application including all third-party verifications Plans must comply by January 1, 2027. Receipt notice within 10 business days. Miss: provisional approval for 120 days only if credentialed by the plan in the past 5 years with no discipline or malpractice reports. Medi-Cal managed care excluded. Cross-checked with UHC addendum.	90 days	State Law	Cal. Health & Safety Code 1374.198; Cal. Ins. Code 10144.565 (AB 1041, 2025) As of October 2026
State Medicaid (Medi-Cal) Medicaid FFS	Physicians and physician groups: DHCS action within 90 days of the application package, else provisional status on day 91 Provisional default suspended July 1, 2026 to June 30, 2027 under subd. (o). DHCS FAQ v2.0 (Apr 3, 2026): physician applications receive a response within 90 days (https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/faq/Medi-Cal_Provider_Enrollment_FAQ.pdf).	90 days	State Law	Cal. Welf. & Inst. Code 14043.26(g) As of October 2026
State Medicaid (Medi-Cal) Medicaid FFS	DHCS written notice on an enrollment application within 180 days, else provisional provider status on day 181 Subd. (o): from July 1, 2026 to June 30, 2027 a missed deadline does NOT grant provisional status; the application stays pending. DHCS Medi-Cal Provider Enrollment FAQ v2.0 (Apr 3, 2026): non-physician license types get a response within 180 days.	180 days	State Law	Cal. Welf. & Inst. Code 14043.26(f) As of October 2026

Credentialing in California

Colorado

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Physicians: credentialing concluded within 60 calendar days of a completed application Receipt notice in 7 days, incomplete notice in 10. If no receipt notice, physician deemed participating by day 53. Mental health providers: 60-day best-efforts target (Bulletin B-4.131). Cross-checked with UHC addendum.	60 days	State Law	C.R.S. 10-16-705.7 As of October 2026
Colorado RAEs (Health First Colorado) Medicaid MCO	Measured: percent of practitioners credentialed and contracted within 90 days June 1-30, 2025: RAEs 1-7 each 100%; PRIME MCO 96.97%. No statewide figure published. Latest dashboard found as of Oct 21 2026.	90 days	Measured Result	Colorado HCPF RAE/BH Accountability and Transparency Dashboard, update July 2025 (data June 2025) As of June 2025
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Credentialing and contracting completed or denied within 90 days for at least 90% of applications Colorado Medicaid (RAE) contract term as stated in the UHC addendum; incomplete applications denied at 80 days. State contract text not independently verified.	90 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Colorado

Delaware

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	From January 1, 2028: 15 days to confirm a clean application, then 30 days to decide (45 days from receipt) Not in effect until January 1, 2028; no comparable statutory deadline before then. Claims paid back to the date a complete application was submitted once credentialed (3308B).	45 days	State Law	18 Del. C. 3305B, 3307B (signed September 2026) As of October 2026

Credentialing in Delaware

Florida

Payer	Rule or target	Days	Type	Source
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Full enrollment within 60 days, from receipt of a complete application to Agency receipt of the provider network (PNV) file Florida SMMC contract term as stated in the UHC addendum. State contract text not independently verified.	60 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Florida

Georgia

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Enrollee-nominated provider only: credentialing decision within 90 days of receiving all necessary information Georgia has no general commercial credentialing deadline; this applies only when an enrollee nominates the provider.	90 days	State Law	Ga. Comp. R. & Regs. 120-2-83-.05 As of October 2026
Georgia Medicaid CMOs (DCH centralized CVO) Medicaid MCO	Decision within 45 calendar days of submission of a complete application through the DCH centralized CVO Official but dated (2015); confirm current CVO turnaround with DCH.	45 days	Medicaid Contract	Georgia DCH: Credentialing Verification Organization Process FAQ (July 14, 2015) As of July 2015

Credentialing in Georgia

Idaho

Payer	Rule or target	Days	Type	Source
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	All provider types processed within 120 calendar days of a completed application and signed contract, including claims loading Idaho Medicaid contract term as stated in the UHC addendum. State contract text not independently verified.	120 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Idaho

Illinois

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Mental health and substance use providers (from 2027): verification and contracting within 60 days of a complete application Plans issued or renewed on or after January 1, 2027. Once contracted, paid at contract rate back to the complete-application date.	60 days	State Law	215 ILCS 5/370c.4 (P.A. 104-0446) As of October 2026
All commercial (state law) Commercial	Credentialing completed within 60 days after all credentials data are submitted and verified Recredentialing no more than once every 3 years. Cross-checked with UHC addendum.	60 days	State Law	410 ILCS 517/15(f) As of October 2026

Credentialing in Illinois

Indiana

Payer	Rule or target	Days	Type	Source
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Applications processed within 30 calendar days of a complete application Indiana Medicaid contract term as stated in the UHC addendum; claims load within 7 business days of credentialing. State contract text not independently verified.	30 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Indiana

Iowa

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Credentialing determination within 56 calendar days of the credentialing request Clean claims for physicians, ARNPs and PAs during the credentialing period paid retrospectively once credentialed. Cross-checked with UHC addendum.	56 days	State Law	Iowa Code 514F.6 As of October 2026

Credentialing in Iowa

Kansas

Payer	Rule or target	Days	Type	Source
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Credentialing completed within 45 calendar days (PSV started within 5 days of a completed application) KanCare contract term as stated in the UHC addendum; claims load within 7 calendar days of committee approval. State contract text not independently verified.	45 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Kansas

Kentucky

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 45 days of an application containing everything the current CAQH form requires Once credentialed and contracted, paid at participating rates for services during credentialing. Cross-checked with UHC addendum.	45 days	State Law	KRS 304.17A-576; 806 KAR 17:480 As of October 2026
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Credentialing completed within 30 days Kentucky Medicaid contract term as stated in the UHC addendum; contract within 30 days of credentialing, load within 10 days of the executed contract; claims payable from the application date. State contract text not independently verified.	30 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Kentucky

Louisiana

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Credentialing completed within 90 days of receiving all required information Defect notice within 30 days of receipt. Provisional claims payment on a completed application under La. R.S. 22:1874 (Act 897), per UHC addendum.	90 days	State Law	La. R.S. 22:1009 As of October 2026
UnitedHealthcare Community Plan (state Medicaid contract terms) Medicaid MCO	Credentialing processed within 60 calendar days Louisiana Medicaid contract term as stated in the UHC addendum; written denial notice within 14 days. State contract text not independently verified.	60 days	Medicaid Contract	UnitedHealthcare Credentialing Plan, Attachment E: State and Federal Regulatory Addendum (rev. 9/2026) As of September 2026

Credentialing in Louisiana

Maine

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 days of a completed application (extendable by notice, never past 180 days) Services from the complete-application date paid once credentialed (4303(2-A)). Completeness notice within 30 days (Rule 02-031-850, per UHC addendum).	60 days	State Law	24-A M.R.S. 4303(2) As of October 2026

Credentialing in Maine

Maryland

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	30 days to give notice of intent to continue a completed application, then accept or reject within 120 days of that notice (about 150 days total) Incomplete applications returned within 10 days. No automatic consequence. Cross-checked with UHC addendum.	150 days	State Law	Md. Code Ann., Ins. 15-112 As of October 2026

Credentialing in Maryland

Massachusetts

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	95% of clean, complete initial applications decided within 60 days of receipt Incomplete notice within 20 business days; status notice by day 75. Recredentialing: 95% within 120 days. Cross-checked with UHC addendum.	60 days	State Law	211 CMR 52.09 As of October 2026

Credentialing in Massachusetts

Minnesota

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 45 days of a clean application (one 30-day extension for a quality or safety concern)	45 days	State Law	Minn. Stat. 62Q.097 As of October 2026

Credentialing in Minnesota

Missouri

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 business days of a completed application (about 84 calendar days) Statute counts 60 business days; max_days is that converted to calendar days (60 x 7/5). Receipt notice in 2 working days. After credentialing, paid for covered services from receipt of the completed application.	84 days	State Law	RSMo 376.1578 As of October 2026

Credentialing in Missouri

New Hampshire

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Primary care and mental health providers: decision within 30 days of a clean and complete application HB 507 (signed 2025, effective January 1, 2026) set 30 days for mental health professionals. Providers may cover on-call for credentialed colleagues before credentialing completes.	30 days	State Law	RSA 420-J:4 (HB 507, 2025) As of October 2026
All commercial (state law) Commercial	Specialists: decision within 45 days of a clean and complete application	45 days	State Law	RSA 420-J:4 As of October 2026
NH Medicaid MCOs Medicaid MCO	within 30 days of a clean, complete primary care application (contract target: at least 98% of applications, SFY 2027)	30 days	Medicaid Contract	NH DHHS Medicaid Quality: TIMELYCRED.01 contract requirement As of October 2026
NH Medicaid MCOs (AmeriHealth Caritas NH, NH Healthy Families, Well Sense) Medicaid MCO	99.3% of clean primary care applications credentialed within 30 days (all MCOs, quarter ending June 2026) Quarterly aggregate since Sept 2022 ranged 88.1% to 100%. Per-MCO values are mostly suppressed for small samples. Excludes providers an MCO delegates to credential themselves.	30 days	Measured Result	NH DHHS Medicaid Quality: Timely Provider Credentialing, Primary Care Providers (TIMELYCRED.01) As of October 2026

Credentialing in New Hampshire

New Jersey

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Written decision within 90 days of a complete application Incomplete notice within 60 days (an HMO that does not send one is treated as having a complete application); CAQH applications marked complete or incomplete within 45 days. No automatic consequence; complain to DOBI.	90 days	State Law	N.J.A.C. 11:24C-1.3 As of October 2026
NJ FamilyCare MCOs Medicaid MCO	MCO credentialing turnaround of 90 days for clean applications (standard in effect per DMAHS, April 2024) Slides list a policy update to reduce turnaround from 90 to 60 days for clean applications; confirm whether 60 days is now in the NJ FamilyCare contract.	90 days	Medicaid Contract	NJ DMAHS/DMHAS Behavioral Health Integration Advisory Hub, April 2024 slides As of April 2024

Credentialing in New Jersey

New Mexico

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 30 days of a complete application (one 15-day extension) Approved providers loaded within 30 days. If missed, insurer pays covered claims for services more than 30 days after receipt of the complete application.	30 days	State Law	NMSA 1978 59A-22-54 As of October 2026

Credentialing in New Mexico

New York

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Within 60 days of a completed application: credentialed, or notice that more time is needed for third-party documents (then 21 days after receipt) Newly licensed or relocated professional joining a fully participating group is provisionally credentialed from day 61. PHL 4406-d applies the same rule to HMOs, including Medicaid managed care plans.	60 days	State Law	N.Y. Ins. Law 4803(a); N.Y. Pub. Health Law 4406-d As of October 2026
State Medicaid (NY Medicaid) Medicaid FFS	Department decides whether to enroll within 90 calendar days, extendable to 120 calendar days with written notice Extension notice must be mailed within 60 calendar days of receipt.	90 to 120 days	State Law	18 NYCRR 504.4 As of October 2026

Credentialing in New York

North Carolina

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 days of a completed application After day 60, on written request, temporary credential within 5 business days (exceptions for malpractice, substance use or board discipline history).	60 days	State Law	N.C. Gen. Stat. 58-3-230 As of October 2026

Credentialing in North Carolina

Ohio

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Credentialing completed within 90 days of first submission of the credentialing form Deficiency notice within 21 days. If missed: $500 per day or retroactive reimbursement for services after day 90. Hospitals excluded.	90 days	State Law	Ohio Rev. Code 3963.06 As of October 2026

Credentialing in Ohio

Oregon

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 90 days of a complete application (license, DEA if applicable, liability coverage) Covered claims during credentialing are paid, possibly out of network. HB 3242 (2025, ch. 126, effective 91st day after sine die) requires in-network pay for a provider joining an in-network group during credentialing, repayable if not credentialed: https://apps.oregonlegislature.gov/liz/2025R1/Measures/Overview/HB3242	90 days	State Law	ORS 743B.454; Or. Laws 2025, ch. 126 (HB 3242) As of October 2026

Credentialing in Oregon

Rhode Island

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 45 calendar days of a complete application Completeness notice within 5 business days; status updates every 15 days. Billing privileges start the next business day after approval.	45 days	State Law	R.I. Gen. Laws 27-18-83, 27-19-74 As of October 2026

Credentialing in Rhode Island

Tennessee

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 90 days of a completed clean CAQH application Status notice within 5 business days. New provider billing under an existing group contract paid in-network from a complete application until approval (56-7-1001(f)). TennCare excluded.	90 days	State Law	Tenn. Code Ann. 56-7-1001 As of October 2026

Credentialing in Tennessee

Texas

Payer	Rule or target	Days	Type	Source
BCBS Texas Commercial	Review of the CAQH credentialing application for completeness takes on average 8 to 10 calendar days Completeness review only, not the full credentialing decision. CAQH must be finalized within 45 days or the file is discontinued; 30 days to correct conflicting information.	8 to 10 days	Payer Published	Blue Cross and Blue Shield of Texas: Credentialing Process for Office Based Physicians or Professional Providers As of October 2026
All commercial (state law) Commercial	HMOs: accept or reject in writing within 90 days of receiving the application Expedited credentialing (Tex. Ins. Code ch. 1452 subch. C): physician joining an established contracted group paid in-network while pending once documents are in.	90 days	State Law	28 Tex. Admin. Code 11.1402 As of October 2026
State Medicaid (Texas Medicaid / TMHP) Medicaid FFS	Enrollment typically takes 60 business days (about 84 calendar days) after all information needed is received Published for pharmacy enrollment through TMHP; source counts 60 business days, converted to calendar days (60 x 7/5). Risk category review and state approvals can extend it.	84 days	Payer Published	Texas HHSC Vendor Drug Program: Enrollment Process As of October 2026
Texas Medicaid and CHIP MCOs Medicaid MCO	Network participation no later than 90 days after receipt of a complete application (centralized CVO verification plus MCO committee) Industry association summary, not the contract text. PSV by the state CVO: 15 calendar days for MDs/DOs, 30 for others; MCO committee within 60 calendar days.	90 days	Medicaid Contract	Texas Association of Health Plans: Credentialing 101 (Fall 2024), summarizing the Uniform Managed Care Contract and Manual As of November 2024

Credentialing in Texas

Vermont

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 days of a completed application Deficiency notice within 30 business days.	60 days	State Law	18 V.S.A. 9408a(f) As of October 2026

Credentialing in Vermont

Virginia

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 days of a completed application (deemed complete 30 days after receipt unless the plan says otherwise) Receipt notice within 10 days. Once credentialed and contracted, pending-period services paid in-network. Medicare Advantage excluded.	60 days	State Law	Va. Code Ann. 38.2-3407.10:1 As of October 2026
All commercial (state law) Commercial	Managed care plan (MCHIP) licensees: credentialing within 90 calendar days of receipt of requested information, or 120 calendar days of receipt of the application if nothing is requested Amended effective November 22, 2023 (Va. Register Vol. 40, Iss. 5). Runs alongside the 60-day statute, which is the tighter clock.	90 to 120 days	State Law	12VAC5-408-170 D(6) (Virginia Department of Health) As of November 2023

Credentialing in Virginia

Washington

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 90 days of a complete application, with the carrier average at 60 days or less Provider added to an existing contract paid from submission of the completed application (EHB 1552, 2020). ProviderSource (OneHealthPort) required.	90 days	State Law	RCW 48.43.750 As of October 2026

Credentialing in Washington

West Virginia

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 120 days (four months) of the completed application, extendable 3 months for verification delays Services during credentialing must be paid; recoverable if the provider is not credentialed.	120 days	State Law	W. Va. Code 33-45-2 As of October 2026

Credentialing in West Virginia

Wyoming

Payer	Rule or target	Days	Type	Source
All commercial (state law) Commercial	Decision within 60 days of the application (paused while an incomplete application is cured) Once credentialed with a signed contract, covered services paid back to receipt of the completed application.	60 days	State Law	Wyo. Stat. 26-56-102 (HB 82, 2025) As of October 2026

Credentialing in Wyoming

What Type Means

State Law: a deadline in a state statute or regulation.
CMS Target: a Medicare processing timeframe CMS sets for its contractors.
Payer Published: what the payer says on its own website or manual.
Medicaid Contract: a turnaround term in a state Medicaid program's managed care contract or policy manual, sometimes as reported by a plan or an industry group (the row says so).
Measured Result: observed performance published by a state agency.
Accreditation Standard: an NCQA requirement for accredited plans.

For what a realistic end to end timeline looks like, and what slows it down, see how long credentialing takes.

Frequently Asked Questions

Is there a legal deadline for insurance credentialing?

In many states, yes. 30 states in this table set a deadline for commercial plans to decide a complete credentialing application, from 30 to 180 days, and some apply only to certain provider types or start in a future year. The clock almost always starts only when the application is complete, as the plan defines it.

How long does Medicare enrollment take?

CMS expects its contractors to finish 95% of initial applications filed online in PECOS within 15 days and all of them within 50 days when no site visit, development request or fingerprinting is needed. With development, the targets are 50 and 85 days. Paper applications get 30 and 65 days. Source: First Coast Service Options (Medicare MAC): CMS-855 enrollment application processing timeframes (CMS-defined).

Are these average credentialing times?

No. Almost every row is a legal deadline, a regulator target, a contract term or the payer's own statement of how long it takes. Only 2 rows, labeled Measured Result, report what actually happened (Colorado and New Hampshire Medicaid managed care reporting). Real timelines depend on how complete the file is and how quickly requests are answered.

What do commercial payers say credentialing takes?

Elevance Health (Anthem): Credentialing typically takes 45 days from receipt of the completed CAQH application. Cigna: Credentialing typically takes 45 to 60 days from receipt of the application packet. UnitedHealthcare: Credentialing takes up to 45 calendar days or more once UHC has a completed application and all required information. These are the payers' own published statements.

How long do Medicaid managed care plans have?

It depends on the state contract. This table lists 13 Medicaid managed care contract terms, from 14 to 120 days, each linked to its source.

A deadline only helps if someone holds the payer to it. PECS submits complete applications, follows up with every payer on a fixed schedule and escalates when a legal deadline passes. Get your self-serve quote.

Summaries of statute, regulation, contract and payer text, not legal advice. Rules change; confirm with the source before relying on a deadline.

By the PECS credentialing team. Updated October 2026.