Eligible provider types and requirements

Learn about provider types listed in the Washington Administrative code (WAC) who are eligible to enroll as a Washington Apple Health (Medicaid) provider.

Are you eligible to be an Apple Health (Medicaid) provider? Visit the Washington State Legislature website to find out.

Eligible provider types

Provider type eligibility is determined by the Washington State Legislature (WAC 182-502-0002). 

Required materials

Additional materials are required for certain provider types. If you are one of the providers below, please submit the following materials with your application.

Materials by provider type

Applied Behavioral Analyst

Ambulance

  • Ambulance license

Ambulatory Surgery Center

  • Department of Health and Human Services-Medicare Certification for Ambulatory Surgery Centers (ASC)

Chemical Dependency Providers

  • Screening, Brief Intervention and Referral to Treatment Certification

Dentist/denturist

  • Conscious Sedation/General Anesthesia Permit (If applicable)
  • Oral surgeons: Oral Maxillofacial Surgery Residency Certification required
  • Access to Baby and Child Dentistry (ABCD) completion of training certification (if applicable)

Durable Medical Equipment (DME)

  • Department of Health and Human Services-Medicare Certification as a Durable Medical Equipment Supplier

Federally Qualified Health Centers (FQHC)

  • Department of Health and Human Services-Medicare Certification for Federally Qualified Health Centers (FQHC)

Home health

  • Home Health License from the Department of Health
  • Medicare certification

Hospitals

  • Clinical Laboratory Improvement Amendments (CLIA) Certificate
  • Medicare certification
  • Hospital license

Laboratory

  • Clinical Laboratory Improvement Amendments (CLIA) Certificate
  • Medicare certification

Licensed midwives

Licensed Mental Health Professionals

Includes psychiatric advanced registered nurse practitioners, independent clinical social workers, advanced social workers, marriage and family therapists, mental health counselors.

Mobile Anesthesia Services

  • To become credentialed to provide mobile anesthesia services with HCA's fee-for-service (FFS) or managed care dental programs, you must hold a Core Provider Agreement as well as a separate Mobile Anesthesia Contract. Please contact contracts@hca.wa.gov for more information.

Psychiatrist

  • Graduation of Psychiatry Resident Program Certificate

Registered Nurse First Assistants (RNFA)

  • Certified Nurse Operating Room (CNOR) Certification from the Competency Credentialing Institute
  • Registered Nurse (RN) License

Contact

Phone: 1-800-562-3022, ext. 16137

Phones are open: Tuesdays and Thursdays from 7:30 a.m. to 4:30 p.m. (Closed from noon to 1 p.m.)

Phones are closed: Mondays, Wednesdays, and Fridays.

Email: providerenrollment@hca.wa.gov