How to become a Medicaid provider in North Carolina
To bill North Carolina Medicaid, enroll through NCTracks Provider Portal, run by GDIT. The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- NCTracks Provider Portal
- Steps
- 6
- Documents
- 5
- Plans listed
- 10
On this page
North Carolina Medicaid enrollment at a glance
To bill North Carolina Medicaid, enroll through NCTracks Provider Portal, run by GDIT. The process has 6 steps, listed below with the documents the state asks for.
- Program
- NC Medicaid (NCDHHS Division of Health Benefits), including NC Medicaid Managed Care
- Enrollment portal
- NCTracks Provider Portal
- Fiscal agent
- GDIT (NCTracks; the enrollment page still lists the call center under the firm name CSRA)
- Application fee
- North Carolina charges a $100 NC Medicaid Provider Application Fee on enrollment and on revalidation/reverification applications. It was waived from late 2021 to June 30, 2023 and reinstated July 1, 2023. Institutional provider types also pay the federal fee, which NCTracks lists as $750 for 2026. 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.
- Fingerprinting
- Fingerprint-based criminal background checks are required for all high-risk providers and for anyone owning 5% or more of one. Fingerprints already on file with Medicare (confirmed in PECOS) can be accepted unless the provider was moved up to high risk. A provider is moved to high risk after a fraud-based payment suspension, an overpayment, an exclusion, or a similar trigger. 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.
- Site visit
- 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. The NCTracks pages we reviewed do not give a state list of provider types that get site visits.
- Revalidation
- NC calls revalidation 'recredentialing' or 'reverification'. It is due every five years, and NC law requires the $100 fee each time. Providers get notices in the NCTracks message inbox, with reminders 50, 20 and 5 days before the due date if they have not applied. A provider who misses the due date is suspended from Medicaid. Recredentialing includes a criminal background check on all owners and managing relationships. Time-limited enrollees, such as out-of-state providers, are exempt.
- Provider manual
- Provider manual
Steps
- Get an NPI, then use the NCTracks Getting Started with Enrollment guide and Provider Permission Matrix to choose the application type
- Submit the enrollment application electronically in the NCTracks Provider Portal with all supplemental documents
- Pay the $100 NC application fee, plus the federal fee for institutional taxonomies unless exempt
- Complete fingerprinting if your provider type is high risk
- NC Medicaid reviews and credentials the application; files with flagged items go to the weekly Credentialing Committee (a clean application averaged about 16 to 22 days in mid-2026)
- Contract with the Standard Plans, Tailored Plans or the Children and Families Specialty Plan; they use your NCTracks enrollment and credentialing data
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Centralized credentialing: yes, through state enrollment. NC Medicaid credentials providers once through NCTracks enrollment and shares the verified data with the Prepaid Health Plans. The plans rely on that data to decide whether a provider meets their quality standard and may not ask providers for their own credentialing information. NCDHHS has paused its planned separate Provider Data Management/Credentialing Verification Organization module, and delegated credentialing is also on hold, so NCTracks remains the single enrollment and credentialing channel. Providers still contract with each plan.
- Plans (state list)
- AmeriHealth Caritas North Carolina, Inc. (Standard Plan)
- Healthy Blue of North Carolina (Standard Plan)
- UnitedHealthcare of North Carolina, Inc. (Standard Plan)
- Carolina Complete Health, Inc. (Standard Plan; merged with WellCare of North Carolina April 1, 2026)
- Alliance Health (Tailored Plan)
- Partners Health Management (Tailored Plan)
- Trillium Health Resources (Tailored Plan)
- Vaya Health (Tailored Plan)
- Healthy Blue Care Together (Children and Families Specialty Plan)
- EBCI Tribal Option (PCCM entity)
Frequently asked questions
How do I become a Medicaid provider in North Carolina?
To bill North Carolina Medicaid, enroll through NCTracks Provider Portal, run by GDIT. The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in North Carolina Medicaid?
North Carolina charges a $100 NC Medicaid Provider Application Fee on enrollment and on revalidation/reverification applications. It was waived from late 2021 to June 30, 2023 and reinstated July 1, 2023. Institutional provider types also pay the federal fee, which NCTracks lists as $750 for 2026. 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.
How often must North Carolina Medicaid providers revalidate?
NC calls revalidation 'recredentialing' or 'reverification'. It is due every five years, and NC law requires the $100 fee each time. Providers get notices in the NCTracks message inbox, with reminders 50, 20 and 5 days before the due date if they have not applied. A provider who misses the due date is suspended from Medicaid. Recredentialing includes a criminal background check on all owners and managing relationships. Time-limited enrollees, such as out-of-state providers, are exempt.