The Combined Application to Become a Medicaid/DDD Approved Provider is open for all services that are currently anticipated to be available in the Medicaid-based, fee-for-service system, through both the Supports Program and the Community Care Waiver.
How Do I Become a Medicaid/DDD Approved Service Provider?
The first step in becoming an approved provider of Division-funded services in the fee-for-service system is to apply for a Medicaid National Provider Identifier (NPI) at the National Plan and Provider Enumeration System (NPPES) web page. (An agency will typically have just one NPI, regardless of the number of services offered or service locations available).
Once the NPI is received, the agency or individual provider must complete the Combined Application to Become a Medicaid/DDD Approved Provider:
The Combined Application serves two purposes:
(1) Applying to become an approved Medicaid provider, -AND-
(2) Applying to become an approved Division of Developmental Disabilities (DDD) provider for the specific services the agency or individual plans to provide (whether through the Supports Program, the Community Care Waiver, or both)
• The Combined Application must be downloaded, printed and mailed via regular postal mail.
• Agencies are strongly advised to retain a copy of their original Combined Application.
• If a provider agency wishes to add services at a later date, the Combined Application must be submitted again for the new services.