SPECIALIZED THERAPIES SERVICES PROVIDER IN NEBRASKA

PROMOTING RECOVERY AND WELL-BEING THROUGH INDIVIDUALIZED THERAPEUTIC INTERVENTIONS

Specialized Therapies Services in Nebraska provide targeted therapeutic interventions for individuals with disabilities, chronic conditions, or recovery needs. These services help enhance mobility, communication, cognitive abilities, and overall quality of life through professional therapeutic support. Specialized Therapies are authorized under the Nebraska Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Specialized Therapies and manages provider enrollment, service authorization, and reimbursement.

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division

Role: Ensures quality standards, service delivery, and compliance for Specialized Therapies under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Specialized Therapies meet HCBS quality, person-centered planning, and participant protection standards.

2. SPECIALIZED THERAPIES SERVICES OVERVIEW

Specialized Therapies support individuals in achieving functional improvement and independence through targeted therapeutic interventions.

Approved providers may deliver:

• Physical Therapy (PT): Improving mobility, strength, and physical function through exercises and manual therapy.

• Occupational Therapy (OT): Enhancing daily living skills, fine motor coordination, and adaptive techniques.

• Speech-Language Therapy (SLP): Improving communication, swallowing, and cognitive-communication skills.

• Behavioral Therapy: Addressing maladaptive behaviors and developing positive coping strategies.

• Music and Art Therapy: Utilizing creative expression to enhance emotional well-being and cognitive function.

• Recreational Therapy: Facilitating social engagement and skill development through structured activities.

• Aquatic Therapy: Using water-based exercises to support rehabilitation and physical health.

All services are delivered according to the Individualized Service Plan (ISP) and tailored to the participant’s specific therapeutic needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Nebraska Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Specialized Therapy provider via the Nebraska Medicaid Provider Enrollment Portal.

• Obtain necessary professional licenses (e.g., PT, OT, SLP, BCBA).

• Maintain general liability and professional liability insurance.

• Develop comprehensive policies for therapy planning, safety protocols, and documentation.

• Ensure staff meet background checks, health screenings, and relevant training requirements.

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Specialized Therapy Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, professional licenses, insurance certificates, and policy manuals.

Program Readiness Review:

• DHHS evaluates provider readiness, including therapeutic protocols, safety procedures, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Specialized Therapy Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Nebraska Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Professional licenses (e.g., PT, OT, SLP, BCBA)

• Proof of general and professional liability insurance

• Specialized Therapies Policy & Procedure Manual including:

  • Assessment, treatment planning, and goal-setting procedures

  • Safety and risk management protocols

  • Staff credentialing, background checks, and ongoing training requirements

  • HIPAA compliance, participant rights, and grievance handling

  • Documentation standards for therapy progress and Medicaid billing

  • Crisis intervention and behavioral support policies

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Specialized Therapy Program Director

Requirements: Master’s degree in therapy (e.g., PT, OT, SLP); state licensure; supervisory experience preferred.

Role: Licensed Therapists (PT, OT, SLP, Behavioral Therapists)

Requirements: Active state licensure; professional certifications; experience in home and community-based settings.

Role: Therapy Aides/Assistants

Requirements: Certification as a PTA, OTA, or Speech Therapy Assistant; supervised by a licensed therapist; background clearance.

All staff must complete:

• Therapeutic intervention training and safety protocols

• HIPAA compliance and participant rights education

• Crisis management and de-escalation techniques

• Annual competency evaluations and continuing education

7. MEDICAID WAIVER PROGRAMS

Specialized Therapies are available under the following Nebraska Medicaid Waivers:

• Aged and Disabled (AD) Waiver

• Traumatic Brain Injury (TBI) Waiver

• Developmental Disabilities (DD) Waiver

• Children with Disabilities Waiver

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Physical therapy to enhance mobility and reduce pain

• Occupational therapy to improve daily living skills

• Speech and language therapy for communication improvement

• Behavioral therapy to develop coping mechanisms and adaptive skills

• Recreational therapy to enhance social and physical well-being

• Aquatic therapy for physical rehabilitation and relaxation

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Nebraska Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Specialized Therapy Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)

Website: https://dhhs.ne.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division

Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEBRASKA SPECIALIZED THERAPIES PROVIDER

WCG supports healthcare providers and therapy practices in launching Medicaid-compliant Specialized Therapy Services in Nebraska, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing support

• Policy manual development tailored to therapeutic interventions and care planning

• Staff credentialing, training program templates, and therapy documentation guidance

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and outreach strategies

• Quality assurance systems for therapy compliance and client safety

• Collaboration with healthcare professionals and community agencies for referrals

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.