Web browser not supported. Please open this website in one of the following browsers: Chrome, Edge, Firefox, Safari. X

Welcome to
DC Medicaid Online Portal

Serving the District to improve healthcare access and outcomes

Medicaid is a District and Federally funded program for eligible individuals and families.

Announcements

Member Eligibility Portal Notice: We are experiencing issues with Member Eligibility functions on the Provider Portal, including eligibility search, verification, and related navigation on the Claims and Pharmacy pages. As a workaround, obtain eligibility information by calling 866-752-9233 to reach our IVR system (Gabby) or to speak with a Contact Center representative.
Attention Billing Providers: Remittance Advices (RAs) for claims processed between 03/02/2026 and 03/06/2026 are now available on the portal.
The portal will be temporarily unavailable daily from 11 p.m. until midnight, Eastern time, beginning Friday, March 6, 2026, through Tuesday, March 31, 2026, for scheduled maintenance.
Update: The issue identified with Electronic Visit Verification (EVV) claims on March 3rd, where some claims were denying incorrectly, has been corrected, and all impacted claims were reprocessed correctly.
Due to the MMIS transition, providers will not receive payment on March 6, 2026. Payments from the new Gainwell MMIS will begin on March 13, 2026. 
If you have not done so already, register for a portal account today and begin testing X12 submissions so your claims can be processed and paid.
Please note: Electronically submitted claims must be transmitted by 3:00 p.m. EST on Fridays to ensure processing in the weekly payment cycle.
Please review the latest bulletin outlining updates to paper billing requirements: Bulletin 2 – Paper Billing Updates.
If you do not receive your portal registration confirmation email, please reach out to the Contact Center at (866) 752-9233, available Monday - Friday, 8 a.m. - 5 p.m. EST.
Please review the latest bulletin outlining required billing changes: Bulletin 1 – Billing Changes.
Welcome to the Gainwell DC Medicaid Online portal. This portal is now open for billing providers and billing agents to register, establish user IDs, generate a new Trading Partner ID, and test submission of electronic X12 837 claims. If you will be submitting electronic claims and have not received a Provider Identification Number (PIN) letter, please contact our EDI help desk at [email protected].
  • General
  • Member
  • Provider
Welcome to DC Medicaid and DC Healthy Families Online portal for providers and members
Sample Image
This website provides information regarding the DC Medicaid Management Information System. Visitors may find helpful website links and documents by navigating to the three-lined menu icon in the upper right corner of the screen. Users are encouraged to click on the tabs above to find helpful tools and information for members, providers, and MCOs. If you are looking to review individual claims, please log in to our secure site using the "Sign In" link at the top right of this page.
Medicaid News
Members
Members of DC Medicaid:

  • Access the Directory of Providers under the Member tab
  • Log in for claims status and notifications
Providers / Trading Partners
Register as a Trading Partner to:

  • Access training schedule and links
  • Download companion guides and provider manuals
  • Contact the provider help desk
  • Submit claims for certification
  • View Medicaid eligibility
  • Check claim status
  • Submit appeals
  • Download 835s
  • How to Apply for Medicaid
  • Medicaid Card Information
  • Report Fraud, Waste, and Abuse
  • Member Hot Links
  • Provider Directory
  • Member Forms
What is Medicaid?

District of Columbia Medicaid is a Joint federal/state health insurance program that provides health care coverage to low-income and/or disabled individuals and families. Medicaid covers many services, including doctor visits, hospital care, prescriptions, mental health services, transportation, and many other services. To be eligible for the Medicaid in the District, applicants must be residents of the District and must meet non-financial and financial eligibility requirements.


Medicaid Enrollment


Things you Must Do to Get Health Care Services: 

Always remember to take your Medicaid ID card every time you go get health services. You should always ask the provider if they accept DC Medicaid before you get services.

Members should keep their current card information, such as name, address, and telephone number, updated with DC Medicaid.

To report fraud, waste, or abuse, please click on the link below.

Fraud, Waste, and Abuse
To view the list of Member forms, please click on the link below OR click on the selection menu in the upper right corner. From the drop-down list, select Useful Links and then the Forms option.


Member Forms

News for Members
We are excited to announce that DC Medicaid fiscal agent services have transitioned to Gainwell Technologies. You can now register for a portal account (see the Register link at the top right of this page) and access your information. Please bookmark this page and check back often for updates.
  • Portal Registration
  • Training
  • Fee Schedules
  • Provider Forms
  • Companion Guides
  • Billing Manuals
  • Provider Contact Information
Enrolled DC Medicaid pharmacies and billing providers must register as a trading partner to exchange PHI. Trading Partner account registration/activation enables access to the secure provider portal for direct data entry of claims and the ability to view prior authorizations, member eligibility inquiries, claim status inquiries, remittance advice, and more. Please click the "Register" link in the upper right menu to register for a portal account. Enter your information in all required fields and follow the instructions. If you do not receive your portal registration confirmation email, please reach out to the Contact Center at (866) 752-9233, available Monday - Friday, 8 a.m. - 5 p.m. EST.
Find Training Here

See the current Training Registration Instructions.

To view the list of provider forms, please click on the below link OR click on the selection menu in the upper right corner. From the drop-down list, select Useful Links and then the Forms option.
Companion Guides provide information for service providers and billing agents regarding how to submit electronic claims and interact with the DC Medicaid system using other X12 transaction types.


Companion Guides


Billing Manuals provide information regarding the DC Medicaid Program.

To download the Billing Manuals, click on the link below OR click on the navigation menu in the right corner of your screen. The Billing Manuals folder is available in Useful Links.


Billing Manuals

Please direct questions about portal registration and training to the Contact Center at (866) 752-9233, available Monday - Friday, 8 a.m. - 5 p.m. EST.

For technical assistance, providers may contact the DC Medicaid helpdesk at: 
[email protected].
News for Providers
See our recent communications sent to DC Medicaid providers regarding the transition to Gainwell becoming DC Medicaid’s new fiscal agent, including information on training and portal registration: 
For Provider Training, Click Here​. 
​We are excited to announce that DC Medicaid fiscal agent services will soon transition to Gainwell. Please bookmark this page and check back often for updated information.