The New Jersey Division of Developmental Disabilities is moving from a contract-based system of service reimbursement to a Medicaid-based, fee-for-service (FFS) reimbursement system.
How Do I Access Services in the New Fee-for-Service System?
Simply put, "fee-for-service" means that payment to a provider happens only after the provider has actually delivered a service to an individual. This differs from the contract-based service system, in which providers are paid prior to the delivery of services.
We know there are many questions and concerns with regard to the Division's implementation of the fee-for-service system. We are working to improve communication between the Division and its constituents, and to develop materials that will assist individuals, families and providers in understanding the new system.
To receive regular updates please subscribe to our e-news bulletin, Division Update, by sending an email to DDD.Communications@dhs.state.nj.us with "Division Update Subscribe" in the subject line.
Fee-for-Service Help Desk: DDD.FeeForService@dhs.state.nj.us
To access Division-funded services in the Medicaid-based, fee-for-service system, individuals must be enrolled on one of two Medicaid waivers:
(1) Supports Waiver ("Supports Program")
(2) Community Care Waiver (CCW)
To learn about the services available through these Medicaid waivers, please review the Supports Program Draft Service Definitions and Qualifications and the Community Care Waiver Draft Service Definitions and Qualifications.
How Do I Become a Medicaid/DDD Approved Provider?
To apply to provide Division-funded services in the new Medicaid-based, fee-for-service system, please visit the Fee-for-Service Provider Portal.
Fee-for-Service Information / Resources
• Supports Program (SP) Draft Service Definitions and Qualifications
• Community Care Waiver (CCW) Draft Service Definitions and Qualifications
• Fee-for-Service Rate Schedule: Quick Reference Guide
• 2015 Graduates Aging Out of the School System Timeline
• Fee-for-Service Implementation Timeline Part II: January - July, 2015
• Support Coordination Ramp-Up Timeline
• Fee-for-Service Provider Portal (Combined Application to Become a Medicaid/DDD Approved Provider available here)
• Support Coordination (Care management model in the new FFS system)
• Supports Waiver ("Supports Program")
• Community Care Waiver (CCW)
• Medicaid Eligibility and DDD
• Day Habilitation Certification for Providers
Fee-for-Service Frequently Asked Questions (FAQs)
• Becoming a Medicaid Provider / Medicaid Claims
• Day Habilitation
Fee-for-Service Tools / Forms
Support Coordination Agency Selection Form
List of Division-Approved Support Coordination Agencies
Boggs Center Guide to Selecting a Support Coordination Agency
Individualized Service Plan (ISP)
Person Centered Planning Tool (PCPT)
Implementing the Rate Structure: Tiering in the Fee-for-Service System
Implementing the Rate Structure: Tiers for Residential and Day Habilitation (Live Presentation to Providers on 02.12.2015)
How is Case Management for DDD Services Changing? An Overview of the Support Coordination Model in the New Fee-for-Service System (Families version)
• Companion Document: Q&A for Support Coordination Webinar (Adobe PDF)
Understanding the New Fee-for-Service System: An Overview for Individuals and Families
Update for DDD Providers on Fee-for-Service Rate Utilization
Fee-for-Service Slide Presentations (Adobe PDF)
• Implementing the Rate Structure: Tiering in the Fee-for-Service System
• Implementing the Rate Structure: Tiers for Residential and Day Habilitation
• How is Case Management for DDD Services Changing? An Overview for Families of the Support Coordination Model in the New Fee-for-Service System
•Understanding DDD System Reforms: An Overview for Emerging Leaders in the Provider Community
•Understanding the New Fee-for-Service System: An Overview for Individuals and Families
• Update for DDD Providers on Fee-for-Service Rate Utilization
To learn about process used to determine fee-for-service rates, please visit the Fee-for-Service Rate-Setting web page.