How to become a Medicaid provider in Oregon
To bill Oregon Medicaid, enroll through Oregon MMIS Provider Portal (or-medicaid.gov). The process has 6 steps, listed below with the documents the state asks for.
- Enrollment portal
- Oregon MMIS Provider Portal (or-medicaid.gov)
- Steps
- 6
- Documents
- 6
- Plans listed
- 15
On this page
Oregon Medicaid enrollment at a glance
To bill Oregon Medicaid, enroll through Oregon MMIS Provider Portal (or-medicaid.gov). The process has 6 steps, listed below with the documents the state asks for.
- Program
- Oregon Health Plan (OHP), Oregon Health Authority (OHA)
- Enrollment portal
- Oregon MMIS Provider Portal (or-medicaid.gov)
- 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. OHA's enrollment page does 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. The OHA enrollment and revalidation pages do not describe a separate state fingerprint process.
- 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 OHA enrollment and revalidation pages do not describe a separate state site visit process.
- Revalidation
- OHA rescreens every actively enrolled provider at least once every 5 years. It mails a notice to the provider's mail-to address. The provider returns the listed forms (for organizations OHA 3972, 3974 and 3975; for payable individuals OHA 3972 and 3975; for other individuals OHP 3113 and OHA 3975) by the due date, ideally online through the MMIS Provider Portal. If the forms are not returned, participation can end under OAR 410-120-1260. A revalidation received within 30 days after inactivation is treated as a revalidation; after that it is treated as a re-enrollment.
- Provider manual
- Provider manual
Steps
- Get an NPI and find your provider type on OHA's enrollment page to see which forms apply
- Organizations and payable individuals file OHA 3972, OHA 3974 (organizations) and OHA 3975, plus any additional form for the provider type. Rendering, ordering, prescribing and referring providers use the non-payable provider forms
- Submit online through the MMIS Provider Portal (recommended) using the current form versions
- Set up direct deposit with form MSC 189
- Report changes within 30 days; email renewed licenses (other than OMB, Pharmacy and Nursing board licenses) to Provider Enrollment
- To serve CCO members (over 90% of OHP), contact each CCO about network enrollment and credentialing
Documents the state asks for
Joining managed-care plan networks
- Credentialing
- Coordinated care organizations (CCOs) serve over 90% of OHP members. Fee-for-service ('Open Card') enrollment with OHA is separate. A provider must contact each CCO, or the CCO's dental network, to enroll and credential. OHA describes no centralized credentialing. A provider denied by a CCO can request OHA's Provider Discrimination Review.
- Plans (state list)
- Advanced Health
- AllCare CCO
- Cascade Health Alliance
- Columbia Pacific Coordinated Care Organization
- Eastern Oregon Coordinated Care Organization
- Health Share of Oregon
- InterCommunity Health Network Coordinated Care Organization
- Jackson Care Connect
- PacificSource Community Solutions - Central Oregon Region
- PacificSource Community Solutions - Columbia Gorge Region
- PacificSource Community Solutions - Marion/Polk
- Trillium Community Health Plan - Southwest
- Trillium Community Health Plan - Tri-County
- Umpqua Health Alliance
- Yamhill Community Care
Frequently asked questions
How do I become a Medicaid provider in Oregon?
To bill Oregon Medicaid, enroll through Oregon MMIS Provider Portal (or-medicaid.gov). The process has 6 steps, listed below with the documents the state asks for.
Is there an application fee to enroll in Oregon 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. OHA's enrollment page does not list a separate state fee.
How often must Oregon Medicaid providers revalidate?
OHA rescreens every actively enrolled provider at least once every 5 years. It mails a notice to the provider's mail-to address. The provider returns the listed forms (for organizations OHA 3972, 3974 and 3975; for payable individuals OHA 3972 and 3975; for other individuals OHP 3113 and OHA 3975) by the due date, ideally online through the MMIS Provider Portal. If the forms are not returned, participation can end under OAR 410-120-1260. A revalidation received within 30 days after inactivation is treated as a revalidation; after that it is treated as a re-enrollment.