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New Jersey - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The New Jersey Division of Developmental Disabilities (DDD) funds non-medical supervision and socialization under the service name Community Based Supports, rather than Adult Companion Services, through the Supports Program and Community Care Program waivers. Agencies seeking to deliver this service must submit the Combined Application to Become a Medicaid/DDD Approved Provider directly to Gainwell Technologies, the state's fiscal agent.

Approval requires applicants to first obtain a National Provider Identifier (NPI) for their administrative office and sign the Attestation for Providers of Individual Supports if delivering in-home care. New Jersey does not require a distinct facility license for this community-based service, relying instead on the Medicaid enrollment and DDD policy manual compliance process to vet provider agencies.

1. Service Definition and Scope

New Jersey does not cover a service explicitly named Adult Companion Services under its current waiver programs. Instead, the state provides non-medical care, supervision, and socialization through Community Based Supports (CBS) under the DDD Supports Program and Community Care Program.

This service provides direct support and assistance for participants, with or without the caregiver present, in or out of the participant's residence, to achieve and maintain increased independence, productivity, and inclusion in the community.

2. Regulatory and Oversight Agencies

The Division of Developmental Disabilities (DDD) operates the waivers and sets provider policy. The Division of Medical Assistance and Health Services (DMAHS) serves as the state Medicaid agency overseeing the federal funding.

Gainwell Technologies acts as the fiscal agent, processing the provider enrollment applications and managing the Medicaid Management Information System (MMIS).

3. Gatekeeping Prerequisites: Who Can Even Apply

New Jersey maintains an open enrollment process for Community Based Supports providers. There is no Certificate of Need, Request for Proposal (RFP), or closed network moratorium blocking new applicants.

Applicants must establish a commercial presence and obtain a National Provider Identifier (NPI) before submitting the Combined Application. The service does not require affiliation with a designated network entity.

4. Licensure and Certification Requirements

Because Community Based Supports are delivered in the community and do not involve medical care or facility-based day programming, New Jersey does not require a specific Department of Health license for this service.

Providers are approved through the Medicaid enrollment process and must adhere to the DDD Policy Manuals for the Supports Program and Community Care Program.

5. Medicaid Provider Enrollment

Agencies must complete the Combined Application to Become a Medicaid/DDD Approved Provider. This application merges the DDD programmatic approval with the DMAHS Medicaid enrollment process.

Completed applications and supporting documents must be mailed to the Gainwell Technologies Provider Enrollment Unit in Trenton.

6. Staffing, Training and Background Checks

Direct support professionals providing Community Based Supports must meet minimum age and education requirements and pass comprehensive background checks.

Agencies are responsible for ensuring all staff complete required DDD-mandated trainings, including modules on abuse and neglect prevention.

7. Documentation, Policies and Records

Approved agencies must maintain comprehensive service records that align with the participant's individualized service plan. Documentation must verify the date, time, and nature of the supports provided.

Agencies must also maintain administrative policies, including a conflict-free policy and emergency backup plans.

8. Billing, Rates and Claims

Community Based Supports are reimbursed on a fee-for-service basis according to the published DDD rate schedule. Claims are submitted through the NJMMIS portal managed by Gainwell Technologies.

Providers must ensure that billed units match the authorized units in the participant's service plan.

9. Approval Sequence and Timeline

The approval process begins with obtaining an NPI, followed by the submission of the Combined Application to Gainwell Technologies. Gainwell reviews the application for completeness and Medicaid compliance.

Once Gainwell approves the Medicaid enrollment, DDD finalizes the programmatic approval, allowing the agency to receive service authorizations.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to missing signatures, incomplete attestations, or failure to provide the correct NPI information.

During post-enrollment monitoring, common findings include inadequate service documentation and failure to maintain current staff background checks.

11. Key Contacts and Resources

The primary point of contact for prospective providers is the DDD Provider Helpdesk. Gainwell Technologies handles specific questions regarding the Medicaid enrollment application status.

Providers should regularly consult the DDD website for policy manual updates and training requirements.

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