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This research investigates the processes, key successes, lessons learned, and policy implications regarding the statewide implementation of Medicaid reimbursement for community violence intervention (“the policy”). This is a multi-state case study, including qualitative analyses from 17 in-depth interviews and focus groups with high-level policymakers and stakeholders at varying stages of implementation. Our results provide a thick description of the policy’s implementation and illustrate how certain strategies may help or hinder this process across unique state contexts. This study fills a critical knowledge gap at a time when the policy is being adopted by more states and receiving strong support from the Federal government. Effective implementation of the policy is key to offsetting the financial burdens associated with community violence interventions and promoting long-term, sustainable programming.