Waiver Consulting Group — Start any program. In any state.

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

Last reviewed: 2026-09-10

South Dakota funds Assistive Technology under the 1915(c) CHOICES Waiver, capping expenditures at $5,000 per participant plan year for devices, equipment, and evaluations. The state allows two distinct pathways for entities to provide this service: applicants must either hold active certification as a Community Support Provider (CSP) from the Department of Human Services Division of Developmental Disabilities under ARSD 46:11:02, or enroll directly as a standard Medicaid vendor through the Department of Social Services.

Because the state permits standard vendors to supply these items without full CSP certification, there are no closed networks, moratoria, or Certificate of Need requirements blocking entry for equipment suppliers. The primary structural precondition for non-CSP vendors is securing an approved authorization in the state's IRIS system prior to dispensing equipment, as claims submitted without a matching IRIS authorization number are automatically denied.

1. Service Definition and Scope

Under the CHOICES Waiver, Assistive Technology encompasses devices, equipment, or appliances that increase a participant's ability to complete activities of daily living or control their environment. The service also covers the clinical evaluation, procurement, setup, and training necessary for the participant or caregivers to operate the equipment.

South Dakota strictly limits this service to items not covered by the Medicaid State Plan. The service cannot be approved primarily for caregiver convenience, restraint, or recreation, and specific exclusions apply to ongoing subscription costs.

2. Regulatory and Oversight Agencies

The South Dakota Department of Human Services (DHS) operates the CHOICES Waiver and manages the clinical and programmatic oversight of Assistive Technology services. Within DHS, the Division of Developmental Disabilities (DDD) is responsible for certifying Community Support Providers and authorizing individual service plans.

The South Dakota Department of Social Services (DSS) serves as the single state Medicaid agency. DSS handles the financial enrollment of all providers, manages the Medicaid Management Information System (MMIS), and processes all claims for waiver services.

3. Gatekeeping Prerequisites: Who Can Even Apply

South Dakota does not impose a Certificate of Need, Request for Proposals (RFP) procurement process, or county sponsorship requirement for Assistive Technology providers. There are genuinely no closed enrollment windows or moratoria blocking new applicants.

The state explicitly defines two eligible applicant categories: certified Community Support Providers (CSPs) and standard vendors. A vendor is defined as a company or agency enrolled as a Medicaid provider but not certified as a DDD provider. Therefore, any legitimate business capable of supplying the equipment can apply directly through the DSS Medicaid portal without prior DHS certification.

4. Licensure and Certification Requirements

Because Assistive Technology is largely a goods-and-equipment service, South Dakota does not issue a specific Assistive Technology license. Providers operating as comprehensive agencies must maintain their Community Support Provider (CSP) certification.

Vendors supplying equipment must maintain standard local and state business licenses applicable to retail or durable medical equipment operations. If the vendor provides clinical evaluations, the evaluating staff must hold the appropriate South Dakota professional licenses (e.g., Occupational Therapy or Speech-Language Pathology).

5. Medicaid Provider Enrollment

All prospective Assistive Technology providers must enroll through the South Dakota Department of Social Services Provider Enrollment (PE) Portal. The enrollment process establishes the provider's billing profile in the state's MMIS.

Providers must sign the Division of Medicaid and Long-Term Care Service Provider Agreement. Vendors must select the appropriate provider type corresponding to durable medical equipment or waiver vendor services during the online application.

6. Staffing, Training and Background Checks

Staffing and training requirements depend entirely on the provider's enrollment type. Certified CSPs must adhere to comprehensive state training mandates for all direct support professionals.

Standard vendors supplying equipment are not subject to the comprehensive DDD training rules, but must ensure that any staff installing equipment or training participants are competent in the specific technology provided.

7. Documentation, Policies and Records

Providers must maintain strict documentation linking the provided equipment to the participant's authorized service plan. The most critical document is the approved authorization in the IRIS system, which dictates the exact items and units allowed.

For physical items, providers must retain purchase receipts, manufacturer warranties, and proof of delivery. Any item exceeding the $500 threshold must have documented proof of insurance or an extended warranty on file.

8. Billing, Rates and Claims

Assistive Technology in South Dakota does not use a fixed fee schedule. Instead, claims are submitted to SD Medicaid as billed charges, and the total reimbursable amount is entered as the actual cost of the item or service.

Providers bill using specific Healthcare Common Procedure Coding System (HCPCS) codes outlined in the FY24 CHOICES rate document. Vendors are strictly prohibited from charging Medicaid more than their usual and customary rate offered to the general public.

9. Approval Sequence and Timeline

The approval sequence begins with the participant's case manager identifying the need and securing an assessment. Once the need is established, the provider submits a quote, and the case manager enters the request into the IRIS system for DHS approval.

For new providers, the DSS Medicaid enrollment process must be completed before any authorizations can be linked to them. The PE Portal enrollment typically takes 30 to 60 days, after which the provider can accept IRIS authorizations.

10. Common Denials and Survey Findings

The most frequent cause for claim denial is submitting a claim without a matching, active authorization in the IRIS system. Because Assistive Technology is billed as actual charges, discrepancies between the authorized quote and the billed amount will also trigger denials.

Auditors frequently cite providers for failing to secure extended warranties on items over $500, or for attempting to bill the waiver for items that are covered under the Medicaid State Plan.

11. Key Contacts and Resources

Providers should direct waiver policy and certification questions to the Department of Human Services Division of Developmental Disabilities. Billing and enrollment technical assistance is handled by the Department of Social Services.

The Dakota at Home program serves as the primary intake and case management coordination point for participants accessing the CHOICES waiver.

See all South Dakota services · South Dakota Medicaid consulting · book a consultation.