Find the right credentialing route before you submit the first claim.
Choose your provider type, region, and payer to find the right credentialing path, then open the payer guide and official source before you apply.
Choose the credentialing path that matches your provider.
Payer names can cover multiple networks and provider types. Select the provider type, region, and program together so you follow the route that actually applies to your practice.
Provider type
Choose the type of provider you are credentialing.
Region
Choose the payer program you need.
Narrow the results to commercial plans, Virginia Cardinal Care, Maryland HealthChoice, or state Medicaid enrollment.
Find the payer guide that fits your provider.
Open a payer guide to review provider type, state enrollment, portal setup, EDI, ERA, EFT, payer IDs, and the steps to confirm before you start billing.
CareFirst BlueCross BlueShield
BH: Use the CareFirst professional network process with CAQH for behavioral health participation. Confirm the exact CareFirst product/network before treating members.
Speech: Use the CareFirst professional network process as a Speech Therapist provider type. Speech is handled as outpatient rehabilitation, not as behavioral health.
UnitedHealthcare / Optum
BH: Apply through Optum Behavioral Health / Provider Express using the behavioral-health provider type that matches the clinician or organization.
Speech: Outpatient speech-language pathologists and therapy clinics credential and contract through Optum Physical Health on behalf of UnitedHealthcare.
Aetna Commercial
BH: Select the Behavioral Health application path in Aetna's network participation process and complete CAQH credentialing.
Speech: Use Aetna's medical/health-care-professional network participation path appropriate to the SLP or therapy organization; do not use the Behavioral Health application solely because the practice also serves behavioral-health patients.
Cigna / Evernorth Behavioral
BH: Apply to the Evernorth Behavioral Health network. Behavioral clinicians, clinics and facilities follow Evernorth behavioral credentialing and CAQH requirements.
Speech: Use Cigna Healthcare's medical credentialing/network process for speech therapy. Do not use the Evernorth Behavioral Health application for SLP.
Kaiser Permanente Mid-Atlantic
BH: Complete Kaiser Mid-Atlantic community-provider onboarding for the behavioral-health provider type and verify current behavioral participation requirements.
Speech: Complete Kaiser Mid-Atlantic network onboarding as a rehabilitation/therapy provider and verify the applicable referral and utilization-management pathway.
Anthem Blue Cross and Blue Shield Virginia
BH: Use Anthem Virginia commercial provider enrollment/CAQH and behavioral-health provider resources.
Speech: Use Anthem Virginia commercial provider enrollment/CAQH as the therapy provider type. Do not route SLP through behavioral-health resources.
Sentara Health Plans
BH: Use Sentara's behavioral-health network/credentialing route. Current behavioral-health network availability is time-sensitive and should be checked before applying.
Speech: Use Sentara's ancillary/therapy provider credentialing route for Speech Therapy and confirm network availability for the SLP provider type.
Virginia Medicaid / Cardinal Care
BH: Enroll through DMAS/MES, then complete behavioral-health participation steps for each applicable Cardinal Care MCO. Behavioral Health Services Redesign requirements are effective-date sensitive.
Speech: Enroll the SLP/provider group through DMAS/MES, then complete the applicable Cardinal Care MCO network enrollment for rehabilitative speech services.
Maryland Medicaid / HealthChoice
BH: Enroll with Maryland Medicaid. For specialty behavioral health, complete the Carelon registration/participation path in addition to state enrollment.
Speech: Enroll with Maryland Medicaid as the therapy provider type. Ages 0–20 SLP routes to Maryland Medicaid FFS under EPSDT; age 21+ generally follows the member's HealthChoice MCO/product.
Aetna Better Health of Virginia
BH: Complete DMAS/MES first, then Aetna Better Health Virginia network credentialing/enrollment. Confirm BH-specific participation requirements.
Speech: Complete DMAS/MES first, then Aetna Better Health Virginia network credentialing/enrollment. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy.
Anthem HealthKeepers Plus
BH: Complete DMAS/MES enrollment, then HealthKeepers Plus credentialing through CAQH/Anthem. Use the behavioral-health resources for BH operations.
Speech: Complete DMAS/MES enrollment, then HealthKeepers Plus credentialing as a speech/medical therapy provider. Speech therapists are credentialed as medical therapy practitioners.
Humana Healthy Horizons of Virginia
BH: Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm BH-specific participation requirements.
Speech: Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy.
Sentara Community Plan
BH: Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm BH-specific participation requirements.
Speech: Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy.
UnitedHealthcare Community Plan of Virginia
BH: Complete DMAS/MES and UHC Community Plan participation; BH clinicians may also require Optum Behavioral Health / Provider Express depending on service and contract.
Speech: Complete DMAS/MES. UHC directs outpatient PT/OT/SLP credentialing through Optum Physical Health; confirm the Virginia Community Plan product is added to the Optum Physical Health participation record.
Aetna Better Health of Maryland
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
CareFirst Community Health Plan of Maryland
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Jai Medical Systems
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Kaiser Permanente Maryland HealthChoice
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Maryland Physicians Care
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
MedStar Family Choice Maryland
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Priority Partners
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
UnitedHealthcare Community Plan Maryland
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Wellpoint Maryland
BH: Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO.
Speech: Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules.
Compare credentialing routes at a glance.
Use the same selections to narrow the table, then choose a payer to open its credentialing guide. Select Official Source when you want to verify a requirement directly with the payer.
| Payer / plan | Region | Program | BH route | Speech route | Before applying | Actions |
|---|---|---|---|---|---|---|
| CareFirst BlueCross BlueShieldBH + SLP | MD / DC / Northern VA | Commercial | Use the CareFirst professional network process with CAQH for behavioral health participation. Confirm the exact CareFirst product/network before treating members. | Use the CareFirst professional network process as a Speech Therapist provider type. Speech is handled as outpatient rehabilitation, not as behavioral health. | Core requirements reviewed | |
| UnitedHealthcare / OptumBH + SLP | VA / MD / DC | Commercial / Behavioral | Apply through Optum Behavioral Health / Provider Express using the behavioral-health provider type that matches the clinician or organization. | Outpatient speech-language pathologists and therapy clinics credential and contract through Optum Physical Health on behalf of UnitedHealthcare. | Payer-family requirements reviewed | |
| Aetna CommercialBH + SLP | VA / MD / DC | Commercial | Select the Behavioral Health application path in Aetna's network participation process and complete CAQH credentialing. | Use Aetna's medical/health-care-professional network participation path appropriate to the SLP or therapy organization; do not use the Behavioral Health application solely because the practice also serves behavioral-health patients. | Core requirements reviewed | |
| Cigna / Evernorth BehavioralBH + SLP | VA / MD / DC | Commercial / Behavioral | Apply to the Evernorth Behavioral Health network. Behavioral clinicians, clinics and facilities follow Evernorth behavioral credentialing and CAQH requirements. | Use Cigna Healthcare's medical credentialing/network process for speech therapy. Do not use the Evernorth Behavioral Health application for SLP. | Verify current application availability before applying | |
| Kaiser Permanente Mid-AtlanticBH + SLP | MD / VA / DC | Mid-Atlantic | Complete Kaiser Mid-Atlantic community-provider onboarding for the behavioral-health provider type and verify current behavioral participation requirements. | Complete Kaiser Mid-Atlantic network onboarding as a rehabilitation/therapy provider and verify the applicable referral and utilization-management pathway. | Core requirements reviewed | |
| Anthem Blue Cross and Blue Shield VirginiaBH + SLP | VA | Commercial | Use Anthem Virginia commercial provider enrollment/CAQH and behavioral-health provider resources. | Use Anthem Virginia commercial provider enrollment/CAQH as the therapy provider type. Do not route SLP through behavioral-health resources. | Core requirements reviewed | |
| Sentara Health PlansBH + SLP | VA | Commercial / Medicaid family | Use Sentara's behavioral-health network/credentialing route. Current behavioral-health network availability is time-sensitive and should be checked before applying. | Use Sentara's ancillary/therapy provider credentialing route for Speech Therapy and confirm network availability for the SLP provider type. | Some enrollment requirements vary by product; confirm before applying | |
| Virginia Medicaid / Cardinal CareBH + SLP | VA | Medicaid | Enroll through DMAS/MES, then complete behavioral-health participation steps for each applicable Cardinal Care MCO. Behavioral Health Services Redesign requirements are effective-date sensitive. | Enroll the SLP/provider group through DMAS/MES, then complete the applicable Cardinal Care MCO network enrollment for rehabilitative speech services. | Program requirements reviewed | |
| Maryland Medicaid / HealthChoiceBH + SLP | MD | Medicaid | Enroll with Maryland Medicaid. For specialty behavioral health, complete the Carelon registration/participation path in addition to state enrollment. | Enroll with Maryland Medicaid as the therapy provider type. Ages 0–20 SLP routes to Maryland Medicaid FFS under EPSDT; age 21+ generally follows the member's HealthChoice MCO/product. | Program requirements reviewed | |
| Aetna Better Health of VirginiaBH + SLP | VA | Cardinal Care | Complete DMAS/MES first, then Aetna Better Health Virginia network credentialing/enrollment. Confirm BH-specific participation requirements. | Complete DMAS/MES first, then Aetna Better Health Virginia network credentialing/enrollment. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy. | Confirm the current credentialing sequence before applying | |
| Anthem HealthKeepers PlusBH + SLP | VA | Cardinal Care | Complete DMAS/MES enrollment, then HealthKeepers Plus credentialing through CAQH/Anthem. Use the behavioral-health resources for BH operations. | Complete DMAS/MES enrollment, then HealthKeepers Plus credentialing as a speech/medical therapy provider. Speech therapists are credentialed as medical therapy practitioners. | Core requirements reviewed | |
| Humana Healthy Horizons of VirginiaBH + SLP | VA | Cardinal Care | Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm BH-specific participation requirements. | Complete DMAS/MES enrollment and Humana Healthy Horizons join-network/credentialing steps. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy. | Confirm current credentialing details before applying | |
| Sentara Community PlanBH + SLP | VA | Cardinal Care | Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm BH-specific participation requirements. | Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy. | Confirm the current payer ID and credentialing details | |
| UnitedHealthcare Community Plan of VirginiaBH + SLP | VA | Cardinal Care | Complete DMAS/MES and UHC Community Plan participation; BH clinicians may also require Optum Behavioral Health / Provider Express depending on service and contract. | Complete DMAS/MES. UHC directs outpatient PT/OT/SLP credentialing through Optum Physical Health; confirm the Virginia Community Plan product is added to the Optum Physical Health participation record. | Core requirements reviewed | |
| Aetna Better Health of MarylandBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed | |
| CareFirst Community Health Plan of MarylandBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed | |
| Jai Medical SystemsBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed; EFT route needs current confirmation | |
| Kaiser Permanente Maryland HealthChoiceBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed | |
| Maryland Physicians CareBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed | |
| MedStar Family Choice MarylandBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Confirm current ERA and EFT enrollment details | |
| Priority PartnersBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Confirm current ERA and EFT enrollment details | |
| UnitedHealthcare Community Plan MarylandBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed | |
| Wellpoint MarylandBH + SLP | MD | HealthChoice | Maintain Maryland Medicaid enrollment. For specialty behavioral health, verify Carelon registration/participation because specialty BH is carved out from the HealthChoice MCO. | Maintain Maryland Medicaid enrollment for the SLP/provider group. Ages 0–20 route speech therapy through Maryland Medicaid FFS/EPSDT; age 21+ follows the MCO's network and benefit rules. | Core requirements reviewed |