How to Become a Medicaid Waiver Provider in North Carolina

North Carolina moved accreditation from the end of the process to the front. Under the August 1, 2025 non-substantive amendment to the Innovations Waiver, national accreditation is required to enroll as a provider of Innovations Waiver services in NC Medicaid — so it is a prerequisite, not something you work toward after your first contract. That single change reorders the plan: accreditation surveys take months and cost money, and nothing downstream can start without one. The second structural fact is that credentialing is now centralized. Providers enroll through a Centralized Credentialing and Re-credentialing process managed by the Department or its designated vendor via NCTracks, replacing the older arrangement where each LME/MCO credentialed its own behavioral health network. You still end up in a network — the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans, operational since July 1, 2024, manage the services and oversee the provider networks — but the credentialing gate is now the state's.

Secure national accreditation, enroll and be credentialed centrally through NCTracks, then establish the network relationship with the Tailored Plan covering your counties.

1. Confirm which accreditation your services require

   Accreditation is now a condition of enrollment for Innovations Waiver services. Confirm the accepted accrediting bodies for your service before you commit to a survey.

   Source
2. Enroll through NCTracks

   Enrollment and credentialing run through NCTracks under the Department's centralized process.

   Source
3. Work with the Tailored Plan for your counties

   Four Tailored Plans each cover assigned counties and manage services for members with serious mental illness, severe substance use disorder, I/DD, or TBI. Your network relationship is with the one covering where you operate.

   Source
4. Read the current service definitions before you commit

   The waiver's service set has moved — Supported Living and Community Living Supports now include remote support, Supported Employment runs in three phases, and Benefits Counseling and expanded telehealth are in scope.

   Source

Most of North Carolina's I/DD services run through LME/MCOs and the Behavioral Health and I/DD Tailored Plans rather than through the state directly. Since July 1, 2024 the Tailored Plans have managed mental health, substance use, I/DD, and TBI services for their assigned counties. Central credentialing through NCTracks establishes that you are qualified; the Tailored Plan for your counties determines whether its members can be served by you. Ask that plan what it requires beyond enrollment before you build a start date around the state process alone.

North Carolina does not publish these in a form we could verify, so we have not guessed at them. Ask directly — and if an answer here would help other providers, tell us and we will add it with its source.

• Which accrediting bodies does NC Medicaid accept for Innovations Waiver services, and is there any transition period for providers already enrolled?

  Ask: NC Medicaid Contact Center, 888-245-0179

• Which Tailored Plan covers your counties, and is it accepting new network providers for your service?

  Ask: The Tailored Plan for your counties

• What does the centralized credentialing application require, and how long does it currently take?

  Ask: NC Medicaid Contact Center, 888-245-0179

• What background screening, staff qualifications, and training apply to the Innovations services you intend to deliver?

  Ask: NC Medicaid Contact Center, 888-245-0179