THERAPY SERVICES PROVIDER IN NORTH DAKOTA

Fatumata Kaba
Sep 18
4 min read

PROMOTING WELL-BEING THROUGH THERAPEUTIC INTERVENTIONS AND SUPPORT

Therapy Services in North Dakota provide individuals with disabilities, chronic conditions, or age-related challenges access to therapeutic care to improve physical, mental, and emotional well-being. These services include a range of therapeutic interventions designed to enhance mobility, communication, and personal growth. Therapy Services are authorized under North Dakota Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: North Dakota Department of Human Services (NDDHS)

Role: Administers Medicaid waiver funding for Therapy Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: North Dakota Medical Services Division (MSD)

Role: Manages Medicaid waiver services and oversees Medicaid provider participation.

Agency: North Dakota Division of Aging Services

Role: Provides oversight for therapy services targeting elderly individuals and adults with disabilities.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Therapy Services meet quality, safety, and person-centered care standards.

2. THERAPY SERVICES OVERVIEW

Therapy Services address specific physical, cognitive, and emotional challenges through targeted therapeutic techniques.

Approved providers may deliver:

Physical Therapy (PT): Improving mobility, strength, and coordination through exercises and interventions.
Occupational Therapy (OT): Supporting daily living skills and adaptive techniques for independence.
Speech and Language Therapy (SLT): Addressing communication disorders and dysphagia (swallowing difficulties).
Behavioral Therapy: Implementing strategies to manage challenging behaviors and enhance social skills.
Cognitive Therapy: Assisting with memory, problem-solving, and cognitive function improvement.
Music and Art Therapy: Promoting self-expression and emotional well-being through creative outlets.
Recreational Therapy: Engaging in physical activities to enhance social participation and well-being.
Mental Health Counseling: Providing therapeutic support for managing emotional challenges.
Trauma-Informed Therapy: Supporting individuals affected by trauma with specialized care.
Documentation: Maintaining accurate records of therapeutic interventions, progress tracking, and client outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the North Dakota Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Therapy Services provider via the North Dakota Medicaid Management Information System (MMIS).
Maintain general liability and professional liability insurance.
Develop policies for therapeutic care, client safety, and service documentation.
Ensure staff complete required background checks, health screenings, and licensure verifications.

4. NORTH DAKOTA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the North Dakota MMIS for Therapy Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, therapy policies, and staff licensure documentation.

Program Readiness Review:

NDDHS and MSD evaluate provider readiness, including care protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

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

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (North Dakota Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Therapy Services Policy & Procedure Manual including:
- Therapeutic intervention protocols and individualized care planning
- Safety and quality assurance procedures for therapy sessions
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for therapy tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Safety, infection control, and hygiene practices
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Therapy Program Director

Requirements: Licensed therapist (PT, OT, SLP, or behavioral therapist) with a Master’s or Doctorate in a relevant field; experience in clinical supervision and therapy program management.

Role: Physical Therapists (PT)

Requirements: Doctorate in Physical Therapy (DPT); North Dakota state license; CPR certification.

Role: Occupational Therapists (OT)

Requirements: Master’s degree in Occupational Therapy; state licensure; experience in rehabilitation and adaptive techniques.

Role: Speech-Language Pathologists (SLP)Requirements: Master’s degree in Speech-Language Pathology; ASHA certification; state licensure.

Role: Behavioral Therapists

Requirements: Certification as a Board Certified Behavior Analyst (BCBA); experience in applied behavior analysis.

All staff must complete: