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

Last reviewed: 2026-09-10

Ohio Administrative Code 5123-9-12 governs Assistive Technology services under the state's Individual Options, Level One, and Self-Empowered Life Funding (SELF) waivers, administered by the Ohio Department of Developmental Disabilities (DODD). The service encompasses consultation, equipment purchase or rental, support and education, and service animal training, capped at a strict $5,000 limit per waiver eligibility span across all components.

Approval to bill this service requires dual enrollment, beginning with DODD agency certification through the Provider Services Management (PSM) system and concluding with an Ohio Department of Medicaid (ODM) provider agreement via the Provider Network Management (PNM) module. Independent (individual) providers are structurally excluded from applying; only DODD-certified agency providers may deliver and bill for Assistive Technology in Ohio.

1. Service Definition and Scope

In Ohio, Assistive Technology is defined as interactive electronic or non-electronic equipment, consultation, and support services that enhance a waiver participant's independence and reduce reliance on paid caregivers. The service is authorized by the county board of developmental disabilities Service and Support Administrator (SSA) and documented in the Individual Service Plan (ISP).

The service is divided into four distinct billable components: Consultation, Equipment, Support, and Service Animal Training. Ohio operates as a Technology First state, mandating that SSAs consider Assistive Technology solutions before authorizing traditional staffing models.

• Consultation: Functional evaluation of technologies to address specific needs, billed on an outcome basis.
• Equipment: Purchase, rental, customization, and maintenance of devices, including software subscriptions.
• Support: Education and training for the individual, family, or paid staff on using the equipment, billed in 15-minute units.
• Service Animal Training: Annual examinations and routine vaccinations for service animals whose initial training was funded by a DODD waiver.
• Financial Limit: Total costs for all components combined cannot exceed $5,000 per waiver eligibility span.
• Equipment Lifespan: Equipment purchased with waiver funds has a presumed useful life of 24 months.

2. Regulatory and Oversight Agencies

The Ohio Department of Developmental Disabilities (DODD) serves as the primary operating agency, responsible for provider certification, rule promulgation, and compliance oversight. DODD manages the initial application process through its Provider Services Management (PSM) system.

The Ohio Department of Medicaid (ODM) retains ultimate authority over the Medicaid program, issuing the final Medicaid provider agreement and managing claims processing through the Provider Network Management (PNM) module and the Electronic Medicaid Billing System (eMBS).

• Operating Agency: Ohio Department of Developmental Disabilities (https://dodd.ohio.gov)
• Medicaid Authority: Ohio Department of Medicaid (https://medicaid.ohio.gov)
• Certification Portal: DODD Provider Services Management (PSM) system (https://dodd.ohio.gov/providers/initial-renewal-certification)
• Enrollment Portal: ODM Provider Network Management (PNM) module (https://ohiopnm.maximus.com)
• Billing System: DODD Electronic Medicaid Billing System (eMBS) (https://dodd.ohio.gov/providers/billing)
• Local Oversight: County Boards of Developmental Disabilities (https://dodd.ohio.gov/about-us/our-programs/county-boards)

3. Gatekeeping Prerequisites: Who Can Even Apply

Ohio strictly limits Assistive Technology provider enrollment to agency providers. Independent (individual) providers are explicitly prohibited from applying for or billing this service under OAC 5123-9-12.

There are no Certificate of Need (CON) requirements, closed networks, or county sponsorship letters required to submit an initial application. However, the applicant must establish a formal business entity registered with the Ohio Secretary of State before initiating the DODD certification process.

• Provider Type Restriction: Only agency providers may apply; independent providers are excluded.
• Business Registration: Must be registered and in good standing with the Ohio Secretary of State.
• Medicaid Agreement: Must hold or concurrently apply for an active Medicaid provider agreement with ODM.
• Technology First Mandate: Providers must align with Ohio's Technology First initiative standards.
• Remote Support Vendor Affiliation: If providing equipment used for Remote Support, the agency must receive training from the Remote Support vendor.

4. Licensure and Certification Requirements

Ohio does not issue a distinct facility license for Assistive Technology providers. Instead, agencies must obtain DODD HCBS Waiver Provider Certification specifically for the Assistive Technology service under OAC 5123-9-12.

The certification process requires the agency's Chief Executive Officer (CEO) to meet specific educational and experience standards, complete initial provider training, and submit a comprehensive policy manual detailing service delivery, incident management, and billing procedures.

• Rule Citation: OAC 5123-9-12 (Home and community-based services waivers - assistive technology).
• CEO Qualifications: Must hold a bachelor's degree or have equivalent verifiable experience in developmental disabilities services.
• Initial Training: CEO must complete DODD-approved initial agency provider training prior to application.
• Application Fee: Non-refundable application fee paid via the PSM system (varies by agency size, typically $800 for small agencies).
• Policy Submission: Must submit written policies on major unusual incidents (MUIs), individual rights, and service documentation.
• Certification Lifespan: Initial certification is valid for up to three years before renewal is required.

5. Medicaid Provider Enrollment

Following DODD certification approval, the agency must finalize its enrollment with the Ohio Department of Medicaid (ODM) through the Provider Network Management (PNM) module. The PNM system serves as the single entry point for all Ohio Medicaid provider enrollments.

The agency must link its DODD certification to its ODM provider profile, submit an IRS W-9 form, and complete an electronic funds transfer (EFT) authorization for claims payment.

• Enrollment System: ODM Provider Network Management (PNM) module.
• Provider Type: Enrolled as an HCBS Waiver Agency Provider.
• NPI Requirement: Must obtain and register a National Provider Identifier (NPI) via the NPPES registry.
• Application Fee: Subject to the federal Medicaid institutional provider application fee (unless waived by Medicare enrollment).
• Required Forms: IRS W-9 and ODM EFT Authorization form.
• Revalidation: Must revalidate Medicaid enrollment every five years through the PNM.

6. Staffing, Training and Background Checks

Agency staff delivering the Support component of Assistive Technology must meet DODD direct support professional (DSP) requirements, including background checks and initial training. Furthermore, staff must receive specific training on the equipment they are supporting.

If the Assistive Technology interfaces with Remote Support services, the agency provider must receive documented training directly from the Remote Support vendor on how to operate and maintain the specific equipment.

• Background Checks: Bureau of Criminal Identification and Investigation (BCI) check required for all staff prior to direct contact.
• Registry Checks: Must check the DODD Abuser Registry, Ohio Nurse Aide Registry, and Medicaid exclusion lists.
• First Aid/CPR: Direct support staff must hold valid First Aid and CPR certification.
• Annual Training: Staff must complete DODD-mandated annual training, including MUI reporting and individual rights.
• Equipment Training: Staff must be trained by the Remote Support vendor on specific devices when applicable.
• Driver Requirements: Staff transporting individuals must have a valid driver's license and insurance.

7. Documentation, Policies and Records

Providers must maintain rigorous documentation to support all claims billed through eMBS. Documentation must align with the individual's Payment Authorization for Waiver Services (PAWS) and the Individual Service Plan (ISP).

For equipment rentals or purchases, the provider must maintain signed agreements detailing whether the individual retains ownership of the equipment at the end of a rental period, as well as receipts for all hardware and software subscriptions.

• Service Documentation: Must record date, time in/out, location, and description of Support services provided.
• Equipment Receipts: Must retain itemized invoices and receipts for all equipment purchases and subscriptions.
• Rental Agreements: Written agreements specifying terms, useful life (24 months), and end-of-term ownership.
• PAWS Alignment: Services delivered must strictly match the authorized units and components in the PAWS.
• Record Retention: All records must be maintained for a minimum of six years from the date of service.
• MUI Reporting: Must maintain a log of all Major Unusual Incidents and Unusual Incidents.

8. Billing, Rates and Claims

Assistive Technology claims are submitted to DODD via the Electronic Medicaid Billing System (eMBS). Rates and billing codes are established in the appendix to OAC 5123-9-12 and vary by the specific component delivered.

Equipment is billed per item, Consultation is billed per outcome, and Support is billed in 15-minute units. The total cost across all components cannot exceed the $5,000 limit per waiver eligibility span.

• Billing System: DODD Electronic Medicaid Billing System (eMBS).
• Support Component: Billed in 15-minute units regardless of ratio size.
• Equipment Component: Billed per item; provider may charge purchase cost plus up to 25% for acquisition/maintenance.
• Rental Billing: Monthly rental charges cannot exceed the manufacturer's suggested price spread over 24 months, plus up to 25%.
• Repair Limits: Labor and repair costs cannot exceed 25% of the equipment's replacement cost.
• Maximum Limit: $5,000 hard cap per waiver eligibility span for all AT components combined.

9. Approval Sequence and Timeline

The approval process is sequential, starting with business registration and concluding with Medicaid enrollment. Applicants must first complete DODD CEO training and gather required policy documents before initiating the PSM application.

Once the PSM application is submitted, DODD typically reviews it within 30 days. If approved, the certification data is transmitted to ODM's PNM system, where the provider completes the final Medicaid enrollment steps.

• Step 1: Register business entity with the Ohio Secretary of State.
• Step 2: CEO completes DODD initial agency provider training.
• Step 3: Submit DODD certification application and policies via the PSM system.
• Step 4: DODD review period (typically 30-60 days, pending requests for additional information).
• Step 5: Link DODD certification to ODM via the PNM module.
• Step 6: ODM finalizes Medicaid provider agreement and issues billing credentials.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incomplete policy manuals, failure of the CEO to meet experience requirements, or missing background checks for agency principals.

During compliance reviews, providers are commonly cited for billing equipment costs that exceed the $5,000 waiver span limit, failing to maintain itemized receipts, or delivering Support services without a valid PAWS authorization.

• Application Denial: CEO lacks verifiable experience in developmental disabilities services.
• Application Delay: Missing or inadequate MUI and incident management policies.
• Survey Citation: Billing for equipment or subscriptions exceeding the $5,000 span limit.
• Survey Citation: Missing documentation of Remote Support vendor training for staff.
• Survey Citation: Failure to maintain signed rental agreements detailing end-of-term ownership.
• Claim Denial: Billing Support units that do not match the authorized PAWS.

11. Key Contacts and Resources

Providers should utilize DODD's official resources for rule interpretations, billing guidance, and Technology First initiatives. The DODD Support Teams and the Rapid Response System (RRS) are available for technical assistance.

For issues related to the Medicaid provider agreement or the PNM module, providers must contact the Ohio Department of Medicaid's integrated help desk.

• DODD Provider Certification: https://dodd.ohio.gov/providers/initial-renewal-certification
• Technology First Support: [email protected]
• ODM Provider Network Management (PNM): https://ohiopnm.maximus.com
• OAC 5123-9-12 Rule Text: https://codes.ohio.gov/ohio-administrative-code/rule-5123-9-12
• DODD Electronic Medicaid Billing System (eMBS): https://dodd.ohio.gov/providers/billing
• Ohio Secretary of State Business Search: https://businesssearch.ohiosos.gov

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