North Dakota - Assistive Technology Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The North Dakota Department of Health and Human Services (ND HHS) funds Assistive Technology through the Autism Spectrum Disorder (ASD) Birth through Twenty Waiver (0842.R03.00) and the traditional Medicaid state plan when deemed medically necessary. Providers must secure preauthorization from the participant's HCBS Case Manager for specific devices and evaluations before delivering services to waiver participants.

Approval requires enrollment through the North Dakota MMIS Web Portal as an atypical or medical equipment provider, depending on the exact devices supplied. Because North Dakota does not issue a distinct facility or agency license for assistive technology, applicants bypass state health facility licensure and proceed directly to Medicaid enrollment using a designated dummy license code ("DUM00000") if they do not hold a separate professional credential.

1. Service Definition and Scope

Under North Dakota Medicaid and the ASD Waiver, Assistive Technology encompasses evaluations, specialized medical equipment, devices, and training designed to increase a participant's functional capability and reduce reliance on paid caregivers. This includes both off-the-shelf items and customized communication or mobility aids.

The service is designed to promote independence and integrate individuals into their communities by providing the technological tools necessary to bypass physical or cognitive limitations.

• Target Population: Individuals ages 0-20 on the ASD Waiver meeting ICF/IID level of care, plus eligible state plan Medicaid members.
• Covered Components: Clinical evaluation for device needs, purchasing or leasing of equipment, and training for the participant and family.
• Exclusions: Items that are not medically necessary or are strictly for recreational purposes.
• Service Limits: Subject to waiver budget caps and individual care plan authorizations.

2. Regulatory and Oversight Agencies

The North Dakota Department of Health and Human Services (ND HHS) Medical Services Division oversees Medicaid enrollment, waiver administration, and provider compliance.

The state utilizes the North Dakota MMIS Web Portal for all provider enrollment applications, claims processing, and electronic transaction management.

• Oversight Agency: North Dakota Department of Health and Human Services (https://www.hhs.nd.gov)
• Waiver Authority: ND HHS Medical Services Division (https://www.hhs.nd.gov/healthcare/medicaid/medicaid-waivers)
• Advocacy and Rights: North Dakota Protection & Advocacy Project (https://www.ndpanda.org)
• Claims System: North Dakota MMIS Web Portal (https://www.hhs.nd.gov/healthcare/medicaid/provider/enrollment-information)

3. Gatekeeping Prerequisites: Who Can Even Apply

North Dakota does not impose a Certificate of Need, closed network moratorium, or county sponsorship requirement for Assistive Technology providers. Any legally established business capable of supplying the authorized equipment and meeting Medicaid provider standards may apply.

Because there is no distinct state licensure for this service, the primary structural requirement is establishing a valid business entity and securing the necessary professional credentials if the agency intends to bill for clinical evaluations rather than just equipment provision.

• Certificate of Need: None exists for this service category in North Dakota.
• Network Status: Open enrollment; no closed RFP or procurement windows apply.
• Prior Approval: Preauthorization from the participant's HCBS Case Manager is required before delivering specific devices.
• Business Registration: Must have a valid EIN and be registered to do business in North Dakota.

4. Licensure and Certification Requirements

North Dakota does not issue a specific "Assistive Technology Provider" license. Providers enroll based on their underlying professional credentials (e.g., occupational therapists for evaluations) or as medical equipment suppliers.

For entities that do not require a professional license to supply authorized equipment, the state provides a specific workaround in the enrollment portal to bypass the licensure fields.

• Facility License: Not required for assistive technology provision.
• Application Workaround: Unlicensed atypical providers enter "DUM00000" for the license number and "Other" for the licensing agency in the MMIS portal.
• Professional Licensing: Evaluators (like OTs or PTs) must hold active North Dakota professional licenses if billing for clinical evaluations.
• Expiration Date Entry: Unlicensed entities use 12/31/9999 as the license expiration date during enrollment.

5. Medicaid Provider Enrollment

Enrollment is processed entirely online through the North Dakota MMIS Web Portal. Providers must complete the Group or Individual application, depending on their business structure, and submit required tax documentation.

The application requires precise matching of corporate names and tax identification numbers with IRS records to avoid automatic rejection.

• Enrollment Portal: North Dakota MMIS Web Portal (https://www.hhs.nd.gov/healthcare/medicaid/provider/enrollment-information)
• Required Form: W-9 matching the exact Legal Name and EIN reported to the IRS.
• Provider Agreement: SFN 1168 must be completed with the signee's Social Security Number and Date of Birth.
• Tax Exempt Status: Non-profits must upload their federal IRS Tax Exempt Letter if applicable.

6. Staffing, Training and Background Checks

Staff qualifications depend on the specific component of the assistive technology service being delivered. Evaluators must meet professional standards, while technicians or trainers must be competent in the specific devices provided.

All managing employees and owners must pass federal exclusion screenings during the enrollment process.

• Evaluator Qualifications: Must be a licensed professional (e.g., Speech-Language Pathologist, OT) if conducting clinical device assessments.
• Background Checks: Required for any staff having direct, unsupervised contact with waiver participants.
• Training Requirements: Staff must be trained on the specific operation, maintenance, and safety protocols of the devices they deliver.
• Sanction Screening: Owners and managing employees must pass federal OIG exclusion checks (Screen 8 of the MMIS application).

7. Documentation, Policies and Records

Providers must maintain detailed records of device delivery, warranties, and training provided to the participant. Documentation must clearly link the delivered item to the preauthorized care plan.

If services are reduced or terminated, specific state forms must be utilized and retained in the client file.

• Delivery Documentation: Signed receipts confirming the participant received the authorized device in working order.
• Preauthorization Records: Copies of the approved service authorization from the ND HHS case manager.
• Denial Notices: SFN 1647 (Notice of Denial/Termination) must be documented with appropriate legal citations if services are reduced.
• Record Retention: Medicaid records must typically be retained for a minimum of five years.

8. Billing, Rates and Claims

Claims are submitted electronically via the North Dakota MMIS Web Portal. Assistive technology is generally billed using specific HCPCS codes authorized in the participant's care plan.

Strict timely filing limits apply, and claims lacking the required preauthorization will be automatically denied by the MMIS system.

• Billing System: North Dakota MMIS Web Portal.
• Timely Filing: Claims must be submitted within one year from the date of service; older claims will deny.
• Preauthorization Requirement: Claims will not pay unless the specific device and cost were preauthorized by the state or case manager.
• Electronic Transactions: Providers select "North Dakota MMIS Web Portal" on Screen 6 of the enrollment application for direct submission.

9. Approval Sequence and Timeline

The process begins with business formation and IRS registration, followed by direct enrollment in the ND MMIS Web Portal. Because there is no state licensure phase, the timeline is dictated entirely by the Medicaid enrollment processing queue.

Once the application is approved, providers must register for Web Access to begin submitting claims.

• Step 1: Obtain EIN and register business entity in North Dakota.
• Step 2: Submit Group or Individual application via the ND MMIS Web Portal.
• Step 3: Upload SFN 1168, W-9, and any required professional licenses.
• Step 4: Receive Medicaid ID and register for Web Access to begin billing.

10. Common Denials and Survey Findings

Enrollment applications are frequently rejected for administrative errors, such as mismatched tax information or missing dummy license codes for unlicensed providers.

Claim denials usually stem from missing preauthorizations or failing to meet the state's strict timely filing deadlines.

• Tax ID Mismatch: Applications deny if the Legal Name and EIN do not exactly match IRS records on the W-9.
• Missing Affiliations: Individual providers failing to link to their Group's Medicaid ID or NPI on Screen 5.
• Timely Filing Violations: Claims submitted past the 1-year deadline automatically deny.
• Unauthorized Services: Billing for devices or evaluations not explicitly listed on the participant's approved waiver care plan.

11. Key Contacts and Resources

Providers should utilize the ND HHS website for enrollment guides, policy manuals, and portal access. The Medical Services Division handles specific waiver and billing inquiries.

The MMIS Web Portal serves as the central hub for both initial enrollment and ongoing claims management.

• ND HHS Provider Enrollment: https://www.hhs.nd.gov/healthcare/medicaid/provider/enrollment-information
• ND Medicaid Waivers Page: https://www.hhs.nd.gov/healthcare/medicaid/medicaid-waivers
• ND Protection & Advocacy: https://www.ndpanda.org
• ND MMIS Web Portal: Accessed via the ND HHS provider enrollment page.

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