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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

Download the most recent My Health GPS Provider Operational Manual.
Posted 10/01/2026
CMS has approved the District’s request to renew its Medicaid section 1115(a) demonstration entitled, “Whole-Person Care Transformation.” Read more here.
Posted 10/01/2026
The DHCF offices and Gainwell Contact Center will be closed Monday, October 12, 2026, for the Indigenous Peoples' Day holiday.
Posted 09/30/26
Comagine Health is updating the process for submitting prior authorization requests for multiple incontinence supplies. The process change will start on October 15, 2026. Comagine is hosting a training webinar on October 7, 2026, at 11 am EST - registration is required. Click here for training information and webinar registration.
Posted 09/18/2026
Recently Updated: The latest issue of the Gainwell DC Medicaid Newsletter is now available! It’s full of news you can use, tips, and links to resources. Click here to download the newsletter.
Updated 09/18/2026
Upcoming Provider Portal Training: We are pleased to announce a series of upcoming training sessions designed to clarify claims processing, provide billing guidance, and help providers effectively navigate and use the Gainwell provider portal. The training will provide valuable guidance on key portal functions and best practices to support your day-to-day operations. Click here for more information.
Posted 08/06/26
Comagine is adding an auto-approval pathway for eyewear and contact prior authorization requests through the Comagine Health Provider Portal (CHPP) beginning on August 3, 2026. Comagine hosted a training webinar - click here for the session recording and presentation slides.
Updated 08/05/26
Please note regarding span billing (example: H2020): If a service is limited to one unit per date of service, each date of service should be billed on separate lines. Span billing is not supported for these codes.
Posted 07/24/26
The portal will be temporarily unavailable on Tuesday evenings from 7 p.m. until approximately 12 a.m. EST and on Sunday mornings from 12 a.m. until 6 a.m. EST for scheduled maintenance.
Posted 07/08/26
We’re aware that some providers are noticing voided claims in their remittance advice. This stems from a system issue, and we’re working diligently to correct it as quickly as possible. We will provide further guidance, and there’s no need to resubmit claims.
Posted 06/22/26
The Conduent physical mailboxes are no longer active, and sending correspondence to an inactive mailing address will cause significant delays. See the Gainwell mailing addresses on our Contact Us page. Please be sure to use the appropriate Gainwell physical mailing address if submitting claims or other forms on paper.
Posted 06/17/26
The process for submitting prior authorization requests for acute care hospital services associated with surgical procedures, transplants, medical procedures, and testing through the Comagine Health Provider Portal (CHPP) changed on May 4, 2026. Click here for training materials and user guides, as well as a CHPP registration packet for new users.
Updated 06/05/2026
A system enhancement related to support of 270 EDI transaction checks for future eligibility dates (up to 90 days) was implemented on May 20, 2026. Providers can use this capability to submit 270 eligibility inquires.
Attention Dental Providers: The Dental Billing Manual has been updated to include the new CDT codes effective 1/1/2026.
We are pleased to share that the issues associated with EVV errors regarding codes T2016 and T2017 have been fully resolved. Claims impacted by these errors have been reprocessed, as appropriate. However, if you notice that any claims have not yet been reprocessed, or if you have questions or need assistance, please contact our Contact Center for support at 1-866-752-9233.
Attention IDD Waiver Providers:
When billing procedure codes T2033 and T2016, only one (1) unit may be billed. If a claim has received a partial payment due to billing more than one unit, please submit an adjustment with one unit billed to ensure correct processing.
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
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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
Upcoming Provider Portal Training: We are pleased to announce a series of upcoming training sessions designed to clarify claims processing, provide billing guidance, and help providers effectively navigate and use the Gainwell provider portal. The training will provide valuable guidance on key portal functions and best practices to support your day-to-day operations. Click here for more information.
Posted 08/21/26
The latest issue of the Gainwell DC Medicaid Newsletter is now available! It’s full of news you can use, tips, and links to resources. Click here to download the newsletter.
Posted 07/01/2026
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.