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New Hampshire - Assistive Technology Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The New Hampshire Department of Health and Human Services (DHHS), Bureau of Developmental Services (BDS), funds Assistive Technology under the Developmental Disabilities (DD), Acquired Brain Disorder (ABD), and In-Home Supports (IHS) waivers. The service covers devices, equipment, functional evaluations, and the certification and training of service animals to increase a participant's independence and reduce reliance on paid staff.

Approval to bill for this service requires enrollment as a Developmental Services provider (Provider Type 236) through the NH MMIS Health Enterprise System Web Portal, which mandates a distinct application and site visit for each individual service location. Furthermore, prior authorization for payment dictates that the specific item must be documented in the participant's Individual Service Agreement (ISA) alongside a healthcare practitioner's recommendation and a functional evaluation, as outlined in N.H. Admin. Code § He-M 524.10.

1. Service Definition and Scope

In New Hampshire, Assistive Technology (AT) encompasses items, equipment, product systems, and the certification and training of service animals used to increase, maintain, or improve the functional capabilities of waiver participants. The service is designed to help individuals perform activities of daily living and communicate with their environment.

Assistive Technology Services include the direct assistance provided to an individual in the selection, acquisition, or use of an AT device. This covers functional evaluations, purchasing, leasing, customizing, maintaining, and repairing devices, as well as coordinating necessary therapies associated with the equipment.

2. Regulatory and Oversight Agencies

The New Hampshire Department of Health and Human Services (DHHS) is the primary state agency overseeing Medicaid waiver services. Within DHHS, the Bureau of Developmental Services (BDS) operates the DD, ABD, and IHS waivers that fund Assistive Technology.

Provider enrollment and claims processing are managed through the NH Medicaid Management Information System (MMIS). BDS Program Integrity is responsible for reviewing application materials to identify and authorize the specific specialties a provider may offer.

3. Gatekeeping Prerequisites: Who Can Even Apply

New Hampshire is actively transitioning its developmental services system to comply with federal CMS conflict-free case management regulations. Historically, providers billed for services through Area Agencies acting as an Organized Health Care Delivery System (OHCDS). Now, providers must enroll directly with Medicaid to bill for services.

To become an AT provider, an entity must establish a distinct Medicaid Billing ID for every physical location where services are coordinated or provided. A mandatory site visit is required for each location before the application can be approved.

4. Licensure and Certification Requirements

New Hampshire does not issue a distinct facility or agency license specifically for "Assistive Technology Providers." Instead, vendors and agencies must enroll as Developmental Services providers through Medicaid. Once enrolled, BDS Program Integrity reviews the provider's application materials to authorize the Assistive Technology specialty.

If the provider also offers certified services (such as residential or day programs), they must work with the Certification & Licensing Department of New Hampshire after becoming enrolled as a Medicaid provider. AT evaluations must be conducted by appropriately licensed healthcare practitioners (e.g., occupational or physical therapists) operating within their New Hampshire scope of practice.

5. Medicaid Provider Enrollment

Providers must enroll directly through the NH MMIS Health Enterprise System Web Portal. All providers operating under the BDS waivers (DD, ABD, IHS) must enroll under a single provider type, regardless of which specific waiver funds the participant.

Organizations must apply as a group-billing provider. Individual employees or practitioners within the organization do not need to enroll as individual non-billing providers for developmental services.

6. Staffing, Training and Background Checks

New Hampshire Medicaid providers are subject to risk determinations during the enrollment process pursuant to N.H. Admin. Code § He-W 520.06. The level of background screening required depends on the risk level assigned to the provider type by DHHS.

Providers designated as high risk, or those with direct or indirect ownership interests in high-risk entities, must undergo comprehensive state and federal criminal background checks, including fingerprinting.

7. Documentation, Policies and Records

To secure prior authorization and justify billing, AT providers must maintain robust documentation linking the requested device or service to the participant's functional goals. The primary vehicle for this documentation is the Individual Service Agreement (ISA).

Records must clearly demonstrate that the AT is medically or functionally necessary and that it does not duplicate services available through other funding streams, such as the Medicaid State Plan or an employer.

8. Billing, Rates and Claims

New Hampshire is phasing out the pass-through billing arrangement where Area Agencies (acting as OHCDS) billed for all services. Providers must now utilize direct billing through the NH MMIS portal for Assistive Technology services.

Claims must be meticulously matched to the specific service location. The Medicaid Billing ID on the claim must correspond exactly to the service location submitted on the initial application.

9. Approval Sequence and Timeline

The approval sequence begins with gathering the necessary documentation and submitting a group provider enrollment application through the NH MMIS portal. Providers must ensure they apply under Provider Type 236 for each physical location.

Following submission, DHHS conducts a risk determination and notifies the provider if fingerprinting is required. A site visit is then scheduled and completed before BDS Program Integrity authorizes the AT specialty.

10. Common Denials and Survey Findings

Applications and claims for Assistive Technology are frequently delayed or denied due to administrative errors during the enrollment transition or incomplete clinical documentation in the ISA.

Failure to establish distinct Medicaid Billing IDs for multiple locations or attempting to bill through legacy Area Agency pass-through systems will result in claim rejections under the new direct-bill framework.

11. Key Contacts and Resources

Providers should utilize the NH MMIS portal for all enrollment and billing activities. Technical assistance for the portal is available directly through the system's help features.

For policy questions regarding the DD, ABD, and IHS waivers, providers should consult the Bureau of Developmental Services and review the He-M 500 series of the New Hampshire Administrative Code.

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