DDD Provider Approval Checklist

Before applying, review the DDD policy manuals for the Supports Program and Community Care Program. These manuals outline the rules that govern how services are delivered under DDD Fee for Service, and understanding them now saves time later.

• Read the Supports Program policy manual
• Read the Community Care Program policy manual

If you plan to offer Day Habilitation, Support Coordination, or Supports Brokerage, there are extra steps required before you submit your application. If none of these apply to you, skip ahead to Step 3.

• Day Habilitation - apply for and receive Provisional Day Habilitation Certification first
• Support Coordination - review DDD's Conflict-Free Policy, then email an Agency Letter of Interest and Conflict-Free Policy to the DDD Provider Helpdesk
• Supports Brokerage - sign the Supports Brokerage Attestation, email it to the DDD Provider Helpdesk, and complete Supports Brokerage Orientation through The Boggs Center

Every provider needs a National Provider Identifier (NPI) - a 10-digit ID issued by CMS. As an agency, you need a Type 2 (organizational) NPI, not a Type 1. Type 1 identifies an individual person and is only for solo practitioners billing under their own name. Since your agency bills under its business name and Tax ID, Type 2 is the correct one.

• Apply through NPPES (nppes.cms.hhs.gov) and select "Organization" when prompted
• Use your agency's legal business name, EIN, and service taxonomy code
• You will need one Type 2 NPI for each physical location where you provide services, or your main administrative office if your services are community-based with no fixed location

Once your NPI is issued, complete the Combined Application to Become a Medicaid/DDD Approved Provider. Mail your completed application, along with any required documents for your specific service, to Gainwell Technologies.

• Providers of Individual Supports (residential or in-home) must also sign and submit the Attestation for Providers of Individual Supports
• Keep a copy of your original Combined Application for your records