Individual Provider Credentialing
What Therapist Credentialing Costs (2026)
Therapist credentialing runs $79 to $450 per payer at the services we checked, and what that buys varies a lot. AdvanceAPractice charges $1,200 total for two commercial payers, including $500 mandatory provider setup and $700 for both applications. Our Individual Provider Credentialing package is $2,250 for five payers with the setup fee included, and we follow each one until the payer gives a written effective date or a final answer. Payers are added one at a time, up to 10 per provider, at the same $350, and Medicare or Medicaid enrollment is $450 per program.
What’s Included
Our individual provider credentialing covers, per payer, the application, CAQH/DataSpring alignment, portal registration, EFT/ERA setup, and follow-up until each payer gives its decision in writing. You sign the applications and attest your own DataSpring profile. If you’d rather we update your profile for you, you can choose to share your sign-in through secure onboarding and change the password when we’re done.
Not open yet, or leaving Headway, Alma, Grow or Rula to start your own practice? First Practice Launch sets up your payers, EHR, scheduling and medical billing together, $1,500 a month for four months or $6,000 paid in full.
Here’s the work behind each selected payer path:
- Application build and submission. We prepare the payer’s application and the business records behind it, submit it, and confirm the payer received and logged it.
- CAQH/DataSpring alignment. We audit your CAQH/DataSpring profile with you so it matches what we send each payer, before any payer pulls it.
- Portals and payment setup. We register you on the insurance portals the enrollment requires and set up EFT and ERA, so payments and remittances route correctly the day a panel goes active.
- Managed follow-up. We follow up on a set schedule, escalate when a file goes quiet, resubmit anything that gets lost, and confirm the effective date as soon as the payer approves. We follow up with each payer at least every 10 business days. If a payer says no or its panel is closed, you get that answer in writing and that payer is complete.
You finish with a written handoff: the effective date, confirmed portals and payment routing, so you know the day you can bill. We begin work within three business days after we receive your completed onboarding information, documents and access.
Government enrollment is $450 per provider for each Medicare, Medicaid or Medicaid managed care program in each state. Adding therapists to a group? Group discounts apply automatically at checkout.
What You Do Yourself
Not much, but it matters. You review and sign the final applications. You keep control of your own DataSpring provider profile (formerly CAQH) and legally attest it, because that attestation belongs to the provider. Your NPPES, CAQH/DataSpring and insurance portal accounts stay in your name, and you keep them if we stop working together.
What Other Credentialing Services Charge
Published prices for therapist credentialing run from $79 to $450 per payer on the pages we checked. That’s a wide spread. What each price includes is the part worth reading closely.
| Source | Published Price | What the Page Says It Covers |
|---|---|---|
| GetPaneled | $79 per payer; $349 for CAQH setup plus five payer enrollments in one state | CAQH and NPI onboarding included with payer enrollment |
| MedSole RCM | $99 per insurance submission | CAQH management, application completion, payer follow-up and contracting support |
| TheraProfessional | $275 to $450 per payer; $900 to $1,800 total for most providers with three to five payers | Separate maintenance retainers start at $99 per month |
| Medwave cost guide (all provider types) | $100 to $300 per provider, per payer | Ongoing maintenance, including revalidation and recredentialing, $600 to $2,400 a year per provider |
| AdvanceAPractice | $500 setup plus $350 per payer; two payers is $1,200 and five is $2,250 | Application, CAQH/DataSpring alignment, portals, EFT and ERA, follow-up until each payer gives its decision in writing |
Prices are as each company published them when we checked in September 2026. They change, so confirm before you buy.
Line up five payers and the gap is real: $349 at one end, $2,250 with us. Before you compare totals, ask every company the same three questions. Does the price end at submission or at a written effective date? Who sets up EFT and ERA? What happens when recredentialing comes around?
Why Per-Payer Prices Differ So Much
Where The Price Stops
Filing is the short part. The payer’s review is the long part, and a price that ends at submission leaves the follow-up to you: status checks, requests for missing documents, resubmissions. Ours runs until the payer approves and confirms an effective date, and you get that date in writing.
EFT/ERA And Portal Setup
Approval doesn’t move money on its own. EFT sends payments to your bank account, ERA sends the remittance detail your billing system posts from, and each payer has its own portal registration. If a quote leaves those out, you’ll set them up yourself or pay for them later.
Recredentialing
Getting on a panel isn’t the last application you’ll file. Payers recredential on a cycle. Cigna Behavioral Health, for example, recredentials each contracted practitioner every three years. Some companies fold that into ongoing maintenance, which Medwave puts at $600 to $2,400 a year per provider. Others price it as its own project, usually for less than the first round.
Profile Maintenance
Your CAQH/DataSpring profile runs on a 120-day attestation cycle, and payers such as Cigna expect you to re-attest on that schedule. Monthly plans exist for exactly this kind of tracking. TheraProfessional’s retainers start at $99 a month, and Medwave puts credentialing management fees at $50 to $200 per provider per month. With us, the attestation stays with you. We align the data, you attest it, and we won’t ever ask for your password.
Costs That Aren’t The Fee
Some of what you need is free. Some of it you’re already paying for. One piece costs you time.
- Your DataSpring profile: $0. DataSpring (formerly CAQH) doesn’t charge providers to use its portal.
- Your NPI: $0. CMS doesn’t charge for an NPI. You apply through NPPES.
- Malpractice coverage. We’ll ask for your current malpractice face sheet or certificate of insurance. The premium is yours, and payer and third-party fees sit outside our price.
- Your time. You upload each record once, in a secure workspace and never by email: photo ID, license, IRS EIN letter (CP 575 or 147C), bank-issued ACH instructions and your practice Type 2 NPI. Then you sign the applications and re-attest your profile every 120 days.
- The wait. Plan on 60 to 120 days per commercial payer from a clean submission. That’s typical, and it’s payer review time no company controls. In-scope work begins within three business days after your completed onboarding packet arrives.
Common Questions
What Does Individual Provider Credentialing Cost At AdvanceAPractice?
Individual Provider Credentialing is $1,200 total for two commercial payers for one therapist, counselor or psychiatric NP. The total includes $500 mandatory setup and $700 for both applications. Five payers total $2,250, and the minimum is two. Every payer after the setup fee is the same $350, added one at a time up to 10 per provider. Government enrollment is $450 per provider per path.
Why Is A $500 Setup Plus $350 Per Payer Higher Than Some Quotes?
Because it runs until each payer gives its decision in writing. Each payer path includes the application, CAQH/DataSpring alignment, portal registration, EFT and ERA setup, and scheduled follow up until the payer gives its decision in writing. A lower quote may stop at submission, so check where each price ends.
Is The CAQH/DataSpring Profile Free?
Yes. DataSpring (formerly CAQH) doesn’t charge providers to use its portal. The profile stays in your name, and you re-attest it every 120 days.
Do I Have To Share My CAQH Password?
No. You keep control of your own DataSpring provider profile and attest it yourself. We audit the data with you so it matches what we send each payer.
How Long Does Therapist Credentialing Take?
That’s typical, but payers control their own decisions and timing, so nobody can guarantee a date.
See Your Exact Price
Pick your payers and any Medicare or Medicaid paths. The builder shows every line before checkout, and provider, payer and state details move to secure onboarding after payment.
Build My PricePrescribing clinician? The same breakdown is here for PMHNP credentialing cost and physician credentialing cost.
Choose The Right Credentialing Path
Opening a practice, adding a provider, moving existing payer relationships, and seeking new contracts require different work. See the price and scope that match your situation.