How to become a Medicaid provider in New Hampshire
To bill New Hampshire Medicaid, enroll through New Hampshire MMIS Health Enterprise Portal, run by Conduent. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- New Hampshire MMIS Health Enterprise Portal
- Steps
- 6
- Documents
- 7
- Plans listed
- 3
On this page
New Hampshire Medicaid enrollment at a glance
To bill New Hampshire Medicaid, enroll through New Hampshire MMIS Health Enterprise Portal, run by Conduent. The process has 6 steps, listed below with the documents the state asks for.
- Program
- New Hampshire Medicaid (Fee for Service and Medicaid Care Management), NH DHHS
- Enrollment portal
- New Hampshire MMIS Health Enterprise Portal
- Fiscal agent
- Conduent (runs the NH MMIS portal and the Provider Relations call center)
- Application fee
- Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. NH DHHS provider pages do not list a separate state fee.
- Fingerprinting
- Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. NH DHHS provider pages do not list which provider types are high risk.
- Site visit
- NH DHHS says moderate- and high-risk providers must have a site visit and limited-risk providers do not. A Medicare site visit done within the past 5 years satisfies the requirement for NH Medicaid revalidation. Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections.
- Revalidation
- Every enrolled provider (billing, rendering and ordering/referring/prescribing) revalidates about every 5 years, online in the MMIS portal only. The state mails and emails notices 60 days and 30 days before the due date and on the due date itself. No extensions are given. A provider who misses revalidation can have claims suspended, then loses fee-for-service enrollment and, after that, its health plan participation. Revalidating with Medicare, with another state or with a health plan does not count. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.
- Provider manual
- Provider manual
Steps
- Get an NPI and pick the application type: individual billing, group, facility/entity, non-billing rendering, or ordering/referring/prescribing
- Fill out the online application in the NH MMIS Health Enterprise Portal (Provider > Enrollment)
- Disclose every owner with 5% or more, controlling interests and managing employees
- Upload the required documents listed in the Submit section, including the signed Provider Participation Agreement
- Wait for state review and approval
- To serve Medicaid Care Management members, contract and credential with each health plan you want to join
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Providers who only serve fee-for-service members need only state enrollment. To serve Medicaid Care Management members, a provider first enrolls with the state, then contracts and credentials with each health plan separately. DHHS pages describe no centralized credentialing. A provider terminated by the state has to re-enroll with the MCOs too.
- Plans (state list)
- AmeriHealth Caritas New Hampshire
- NH Healthy Families
- WellSense Health Plan
Frequently asked questions
How do I become a Medicaid provider in New Hampshire?
To bill New Hampshire Medicaid, enroll through New Hampshire MMIS Health Enterprise Portal, run by Conduent. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in New Hampshire Medicaid?
Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. NH DHHS provider pages do not list a separate state fee.
How often must New Hampshire Medicaid providers revalidate?
Every enrolled provider (billing, rendering and ordering/referring/prescribing) revalidates about every 5 years, online in the MMIS portal only. The state mails and emails notices 60 days and 30 days before the due date and on the due date itself. No extensions are given. A provider who misses revalidation can have claims suspended, then loses fee-for-service enrollment and, after that, its health plan participation. Revalidating with Medicare, with another state or with a health plan does not count. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.