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New Hampshire - Occupational Therapy Service — 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 Occupational Therapy Services through the Developmental Disabilities (DD), In-Home Supports (IHS), and Acquired Brain Disorder (ABD) waivers.

Approval requires individual or facility licensure through the Office of Professional Licensure and Certification (OPLC) and direct-bill enrollment through the NH MMIS Health Enterprise Portal. Providers must register their business with the NH Secretary of State and coordinate with regional Area Agencies to receive service authorizations.

1. Service Definition and Scope

Occupational Therapy in New Hampshire's HCBS waivers focuses on evaluating and treating individuals to restore or maintain function in daily occupations.

Services must be authorized in the individual's service agreement and delivered in home and community-based settings.

2. Regulatory and Oversight Agencies

Oversight is split between professional licensure and Medicaid waiver administration.

The OPLC handles professional licensing, while DHHS manages Medicaid enrollment and waiver compliance.

3. Gatekeeping Prerequisites: Who Can Even Apply

New Hampshire does not use a Certificate of Need or closed RFP process for Occupational Therapy services.

However, providers must establish their business entity and coordinate with regional Area Agencies to receive referrals.

4. Licensure and Certification Requirements

Occupational Therapists must hold an active license from the NH OPLC.

Licenses must be renewed biennially with required continuing education.

5. Medicaid Provider Enrollment

Enrollment is processed through the NH MMIS Health Enterprise Portal.

Providers must submit specific documentation, including a signed Provider Participation Agreement.

6. Staffing, Training and Background Checks

Staff must meet professional qualifications and pass background checks.

Training requirements are dictated by BDS and professional licensing standards.

7. Documentation, Policies and Records

Providers must maintain clinical and billing records compliant with DHHS and CMS standards.

Documentation must align with the authorized service plan.

8. Billing, Rates and Claims

Claims are submitted directly to NH MMIS.

Providers must select the appropriate electronic submission method during enrollment.

9. Approval Sequence and Timeline

The process follows a strict sequence from business formation to Medicaid enrollment.

Providers must complete each step before moving to the next.

10. Common Denials and Survey Findings

Applications are often delayed due to missing documentation or incorrect provider type selection.

Providers must ensure all required forms are uploaded to the NH MMIS portal.

11. Key Contacts and Resources

Primary contacts for enrollment and licensure.

Providers should utilize these resources for application status and regulatory guidance.

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