Medicaid Expansion Program - Provider Information

BCBSND administers coverage for North Dakota’s Medicaid Expansion Program, which enables more people to access affordable coverage and preventive services.

While Medicaid Expansion builds on the success of traditional Medicaid, the benefits, systems and credentialing processes of the two programs may differ.

Provider credentialing

To be a provider in the North Dakota Medicaid Expansion Program, you must become credentialed with the State of North Dakota and BCBSND. 

Current BCBSND Providers

To request a Medicaid Expansion addendum, please send an email to providercontracting@bcbsnd.com.

New BCBSND Providers

You can join the BCBSND network and become credentialed for the North Dakota Medicaid Expansion Program by applying to be a BCBSND provider.

Providers Not Enrolled with BCBSND

If you are not a current BCBSND provider and want to be credentialed only for North Dakota Medicaid Expansion, you can enroll with the State of North Dakota. Once directed to the website, click on the Enrollment information link.

1915(i) Providers

Providers who deliver home- and community-based services to individuals with behavioral health conditions can enroll as a North Dakota Medicaid 1915(i) provider with the State of North Dakota.

Once credentialed with NDDHS ND Medicaid, information will be sent to BCBSND to set the provider information up internally. To learn more about claim submission and additional online tools available, utilize our Availity Essentials information page as well as the Medicaid Expansion Provider Manual.

Non-Emergency Medical Transportation (NEMT) Providers

Providers of NEMT are required to enroll to become credentialed with the state of North Dakota for the North Dakota Medicaid Expansion program. Information regarding Medicaid enrollment can be found at North Dakota Department of Human Service (NDDHS). 

Once credentialed with NDDHS ND Medicaid, learn more on how to participate in the BCBSND Medicaid Expansion network.

Meal and Lodging Providers

Providers of meals and lodging can become credentialed for North Dakota Medicaid Expansion through the State of North Dakota.

Pharmacy

Retail outpatient pharmacy benefits are administered by the North Dakota Department of Human Services.

North Dakota Dept. of Human Service Preferred Drug List

A list of Prescription Medications or Drugs that may be covered under the medical benefit and may require Precertification (Prior Approval) for Medicaid Expansion member.                

BCBSND Medicaid Expansion Restricted Use List – Precertification

Coordinated Services Program

Medical and Pharmacy Services Coordinated Services Program (CSP) Referral and Specialist Request Form