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North Dakota - Speech & Language Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The North Dakota Department of Health and Human Services (HHS) Medical Services Division reimburses Speech and Language Pathology (SLP) services through the Medicaid State Plan and Home and Community-Based Services (HCBS) waivers. Approval requires an active license from the North Dakota State Board of Examiners on Audiology and Speech-Language Pathology (NDSBEASLP) prior to submitting the SFN 615 Medicaid Provider Agreement via the MMIS Web Portal.

Applicants must secure this state licensure, which mandates a master's degree and a background check packet, before the state will process any Medicaid enrollment application. Out-of-state providers utilizing telehealth must submit the OOS Telehealth Attestation alongside their enrollment packet to bypass out-of-state authorization requirements.

1. Service Definition and Scope

In North Dakota, Speech and Language Services encompass the evaluation and treatment of communication, cognition, and swallowing disorders. These services are delivered to Medicaid members to restore or improve functional abilities compromised by illness, injury, or developmental disability.

Services must be ordered or rendered within the scope of practice defined by North Dakota Century Code and the NDSBEASLP. Telehealth delivery is permitted for members located in North Dakota, provided the practitioner complies with all state licensing requirements.

2. Regulatory and Oversight Agencies

Multiple state entities govern the licensure and Medicaid enrollment of SLP providers in North Dakota. The primary licensing body ensures clinical competency, while the state Medicaid agency manages provider agreements and claims.

Providers must maintain compliance with both the licensing board's administrative rules and the Medicaid billing manuals published by HHS.

3. Gatekeeping Prerequisites: Who Can Even Apply

North Dakota does not require a Certificate of Need (CON) for independent speech-language pathology practices. However, strict professional licensure prerequisites act as the primary gatekeeping mechanism.

An applicant cannot initiate the Medicaid enrollment process without first holding an active, unencumbered license from the NDSBEASLP. There are no closed networks or mandatory managed care affiliations required to enroll as a fee-for-service Medicaid provider for this service.

4. Licensure and Certification Requirements

To practice as an SLP in North Dakota, individuals must meet the educational and clinical standards set by the NDSBEASLP. This includes completing a master's degree in speech-language pathology from an accredited institution.

The licensure process requires the submission of official transcripts, proof of clinical practicum, and a comprehensive background check packet.

5. Medicaid Provider Enrollment

Enrollment is conducted entirely through the ND MMIS Web Portal. Providers must complete the General Individual Application Requirements and sign the SFN 615 Medicaid Provider Agreement.

Upon approval, providers receive a 7-digit Medicaid ID number via USPS, which is used to register for web portal access for claims and eligibility verification.

6. Staffing, Training and Background Checks

Medicaid-enrolled SLP practices must ensure that all rendering staff meet state licensure and background check requirements. Unlicensed personnel cannot bill for services.

Supervising providers are responsible for the clinical direction of limited license providers and must adhere to the supervision definitions outlined in North Dakota Administrative Code.

7. Documentation, Policies and Records

Providers must maintain legible medical and financial records that fully justify the extent of services billed to ND Medicaid. ND Medicaid acts as a health oversight agency under HIPAA, permitting access to these records without patient authorization.

Record amendments must follow strict guidelines, and practices such as back-dating, post-dating, or writing over existing documentation are strictly prohibited.

8. Billing, Rates and Claims

Claims must be submitted using standard CPT codes for speech and language services. ND Medicaid incorporates the National Correct Coding Initiative (NCCI) methodologies to prevent improper payments.

Providers must accept Medicaid payment as payment in full, except for any recipient liability that must be collected directly from the member.

9. Approval Sequence and Timeline

The approval sequence begins with obtaining the NDSBEASLP license, followed by the submission of the Medicaid enrollment application via the MMIS portal. HHS reviews the application for completeness and verifies licensure and exclusion status.

Processing times vary, but providers can request a retroactive enrollment effective date up to 90 days prior to the application submission, provided they were fully licensed and rendered covered services during that period.

10. Common Denials and Survey Findings

Medicaid enrollment applications are frequently delayed or denied due to missing documentation, such as the OOS Telehealth Attestation for out-of-state providers, or failure to complete the security information section.

Post-payment audits often cite providers for inadequate documentation that fails to justify the services billed, or for improper supervision of limited license personnel.

11. Key Contacts and Resources

Providers should utilize the official state portals and manuals for the most current requirements. The ND Medicaid Billing and Policy Manual is updated regularly and serves as the definitive guide for enrolled providers.

For specific enrollment questions, providers can contact the Medical Services Division directly.

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