Credentialing Deadline Laws by State
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
29 states set a deadline for commercial health plans to decide a credentialing application, ranging from 30 days (New Hampshire and New Mexico) to 150 days (Delaware's takes effect in 2028). 21 states also require payment for services provided while the application is pending, or back to the application date once approved. 22 jurisdictions mandate the application form. The table summarizes each state's rule with its citation; the state pages have the detail.
| State | Deadline | Application form | Paid while pending |
|---|---|---|---|
| Alabama | None found | Plan’s choice | No rule found |
| Alaska | None found | Plan’s choice | No rule found |
| Arizona | 60 days A.R.S. §§ 20-3453, 20-3454 (amended 2025, effective March 31, 2026; previously 100 days) | Plan’s choice | Yes A.R.S. § 20-3456 |
| Arkansas | 60 days Ark. Code Ann. § 23-99-411 | State form Ark. Code Ann. § 17-95-107 | Yes Ark. Code Ann. § 23-99-411 |
| California | 90 days (from 2027) Cal. Health & Safety Code § 1374.198; Cal. Ins. Code § 10144.565 | CAQH Cal. Health & Safety Code § 1380.2; Cal. Ins. Code § 10110.9 | Yes Cal. Health & Safety Code § 1374.198 |
| Colorado | 60 days C.R.S. § 10-16-705.7 | Plan’s choice | Yes C.R.S. § 10-16-705.7 |
| Connecticut | None found | Plan’s choice | No rule found |
| Delaware | 45 days (from 2028) 18 Del. C. §§ 3305B, 3307B (signed September 2026) | CAQH 18 Del. C. § 3303B | Yes 18 Del. C. § 3308B |
| Washington, DC | None found | CAQH D.C. Code § 31-3252 | No rule found |
| Florida | None found | Plan’s choice | No rule found |
| Georgia | None found | Plan’s choice | No rule found |
| Hawaii | None found | Plan’s choice | No rule found |
| Idaho | None found | Plan’s choice | No rule found |
| Illinois | 60 days 410 ILCS 517/15(f); 215 ILCS 5/370c.4 | State form 410 ILCS 517/15 (Health Care Professional Credentials Data Collection Act) | Yes 215 ILCS 5/370c.4 (P.A. 104-0446) |
| Indiana | Notices only Ind. Code § 27-8-11-7 | CAQH Ind. Code § 27-8-11-7 | Yes Ind. Code §§ 27-8-11-7, 27-8-11-13 |
| Iowa | 56 days Iowa Code § 514F.6 | Plan’s choice | Yes Iowa Code § 514F.6(1) |
| Kansas | None found | State form Kansas Insurance Department Bulletin 1999-2 | No rule found |
| Kentucky | 45 days KRS 304.17A-576 | State form or CAQH 806 KAR 17:480 | No rule found |
| Louisiana | 90 days La. R.S. 22:1009 | State form or CAQH La. R.S. 22:1009 | No rule found |
| Maine | 60 days 24-A M.R.S. § 4303(2) | Plan’s choice | Yes 24-A M.R.S. § 4303(2-A) |
| Maryland | 150 days Md. Code Ann., Ins. § 15-112 | CAQH Md. Code Ann., Ins. § 15-112.1 | No rule found |
| Massachusetts | 60 days 211 CMR 52.09 | State form 211 CMR 52.09 | No rule found |
| Michigan | None found | Plan’s choice | No rule found |
| Minnesota | 45 days Minn. Stat. § 62Q.097 | Plan’s choice | No rule found |
| Mississippi | None found | State form 19 Miss. Admin. Code Pt. 3, R. 11.07 | No rule found |
| Missouri | 60 days RSMo § 376.1578 | Plan’s choice | Yes RSMo § 376.1578 |
| Montana | None found | Plan’s choice | No rule found |
| Nebraska | None found | Plan’s choice | No rule found |
| Nevada | None found | State form NRS 629.095; NAC 679B.0405 | No rule found |
| New Hampshire | 30 days RSA 420-J:4 | Plan’s choice | No rule found |
| New Jersey | 90 days N.J.A.C. 11:24C-1.3 | State form N.J.A.C. 11:24C-1.3 | No rule found |
| New Mexico | 30 days NMSA 1978 § 59A-22-54 | State form NMSA 1978 § 59A-22-54 | Yes NMSA 1978 § 59A-22-54 |
| New York | 60 days N.Y. Ins. Law § 4803(a); N.Y. Pub. Health Law § 4406-d | Plan’s choice | Yes N.Y. Ins. Law § 4803(a)(2) |
| North Carolina | 60 days N.C. Gen. Stat. § 58-3-230 | State form N.C. Gen. Stat. § 58-3-230 | Yes N.C. Gen. Stat. § 58-3-230 |
| North Dakota | None found | Plan’s choice | No rule found |
| Ohio | 90 days Ohio Rev. Code § 3963.06 | CAQH Ohio Admin. Code 3901-1-58 | Yes Ohio Rev. Code § 3963.06 |
| Oklahoma | None found | State form 63 O.S. § 1-106.2; OAC 310:2-15 | No rule found |
| Oregon | 90 days ORS 743B.454 | Plan’s choice | Yes ORS 743B.454; Or. Laws 2025, ch. 126 |
| Pennsylvania | None found | Plan’s choice | No rule found |
| Rhode Island | 45 days R.I. Gen. Laws §§ 27-18-83, 27-19-74 | Plan’s choice | No rule found |
| South Carolina | None found | Plan’s choice | No rule found |
| South Dakota | None found | Plan’s choice | No rule found |
| Tennessee | 90 days Tenn. Code Ann. § 56-7-1001 | Plan’s choice | Yes Tenn. Code Ann. § 56-7-1001(f) |
| Texas | 90 days 28 Tex. Admin. Code § 11.1402 | State form Tex. Ins. Code § 1452.052 | Yes Tex. Ins. Code ch. 1452, subch. C |
| Utah | None found | Plan’s choice | No rule found |
| Vermont | 60 days 18 V.S.A. § 9408a(f) | CAQH 18 V.S.A. § 9408a(b) | No rule found |
| Virginia | 60 days Va. Code Ann. § 38.2-3407.10:1 | Plan’s choice | Yes Va. Code Ann. § 38.2-3407.10:1 |
| Washington | 90 days RCW 48.43.750 | State form RCW 48.43.750 | Yes Laws 2020 (EHB 1552) |
| West Virginia | 120 days W. Va. Code § 33-45-2 | Plan’s choice | Yes W. Va. Code § 33-45-2 |
| Wisconsin | None found | Plan’s choice | No rule found |
| Wyoming | 60 days Wyo. Stat. § 26-56-102 (2025) | State form Wyo. Stat. § 26-56-102 | Yes Wyo. Stat. § 26-56-102 |
What the Deadlines Mean in Practice
Every deadline runs from a complete or clean application, and the plan decides what complete means. A missing attestation, an expired malpractice certificate or an unexplained work-history gap produces an incomplete notice, and in most states that stops the clock or restarts it. The statutes also cover credentialing only: contracting, fee schedules and loading the provider into the claims system can run on top, although Arizona, New Mexico and Colorado set loading or deemed-participation rules too.
The payment rules differ more than the deadlines. Some states pay back to the application date once approved (Arkansas, Maine, Missouri, Wyoming), some pay providers joining a contracted group in-network while they wait (Tennessee, Texas, Oregon), and some trigger provisional credentialing, a temporary credential or a penalty when the plan misses its deadline (California, New York, North Carolina, Ohio). Where no rule exists, services before the effective date are usually not payable, so the start date is planned around the approval.
Questions About State Credentialing Laws
Is there a law on how long insurance credentialing can take?
In 29 states, yes. They give commercial plans between 30 and 150 days to decide a complete application (the middle value is 60 days). In the other 21 jurisdictions (including DC) we found no deadline statute, so timing follows each plan's policy.
Which states pay providers while credentialing is pending?
21 states have a rule that pays for services during the credentialing period or back to the application date, in some cases only for providers joining a contracted group: Arizona, Arkansas, California, Colorado, Delaware, Illinois, Indiana, Iowa, Maine, Missouri, New Mexico, New York, North Carolina, Ohio, Oregon, Tennessee, Texas, Virginia, Washington, West Virginia, Wyoming.
Which states require CAQH or a standard credentialing application?
22 jurisdictions mandate a specific application or form: Arkansas, California, Delaware, Washington, DC, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Texas, Vermont, Washington, Wyoming. The rest let each plan choose, and most commercial plans use CAQH ProView (DataSpring) anyway.
What counts as a complete application?
Each statute defines it, but the clock almost always starts only when the plan has everything it asks for: a complete and attested CAQH (DataSpring) profile, license, DEA where applicable, malpractice face sheet and work history. An incomplete notice stops or restarts the clock, which is why a clean file on day one matters more than the statute.
Answers cover PECS services, prices and process. For legal, tax or clinical questions please consult a professional.
Summaries of statute and regulation text, not legal advice. Laws change; confirm with the state insurance department. Each state page links its source. Compiled October 8, 2026.