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Tennessee - I/DD Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In Tennessee, becoming a provider of Intellectual and Developmental Disabilities (I/DD) services requires credentialing through the Department of Disability and Aging (DDA), formerly the Department of Intellectual and Developmental Disabilities (DIDD). Services are funded through the 1915(c) waivers, Employment and Community First (ECF) CHOICES, and Katie Beckett programs.

The credentialing process is centralized under DDA, which serves as the credentialing authority for all I/DD waiver services. Providers must complete the DDA Credentialing Application and, depending on the service, obtain the appropriate license from the DDA Office of Licensure before they can contract with Managed Care Organizations (MCOs) or bill TennCare.

1. Service Definition and Scope

Tennessee's I/DD service array encompasses a broad range of supports designed to help individuals live and work in their communities. These services are delivered through several programs, including the 1915(c) waivers, ECF CHOICES, and Katie Beckett (Parts A and B).

The scope of services ranges from residential supports like Supported Living and Residential Habilitation to day services, employment supports, and specialized therapies. Each service has specific definitions and requirements outlined in the DDA Service Definitions (Attachment 4 of the credentialing packet).

2. Regulatory and Oversight Agencies

The primary oversight agency for I/DD services in Tennessee is the Department of Disability and Aging (DDA). DDA handles both provider credentialing and licensure for most I/DD services.

TennCare is the state Medicaid agency responsible for overall program administration and funding. Managed Care Organizations (MCOs) manage the ECF CHOICES and CHOICES programs, requiring providers to contract with them after DDA credentialing.

3. Gatekeeping Prerequisites: Who Can Even Apply

Before submitting a credentialing application, prospective providers must meet specific prerequisites. DDA requires all applicants to complete these prerequisites prior to application submission.

A critical requirement is that providers must attend an optional but highly recommended Provider Credentialing Application Forum. Additionally, providers must have the appropriate business licenses and tax documentation ready.

4. Licensure and Certification Requirements

Licensure requirements vary based on the specific service being provided. The DDA Office of Licensure issues licenses for many I/DD services, such as Supported Living and Residential Habilitation.

Some services, like certain therapies, require a Professional Support Service License (PSSL) issued by DDA. Other services may not require a specific DDA license but do require staff training and certification.

5. Medicaid Provider Enrollment

After successfully completing the DDA credentialing process, providers must enroll with TennCare. For 1915(c) and ECF CHOICES, DDA forwards the credentialed provider's information to the MCOs for contracting.

For Katie Beckett Part B services, providers must complete a provider agreement in the Provider Data Management System (PDMS) portal to receive a welcome letter from TennCare.

6. Staffing, Training and Background Checks

Tennessee mandates strict background checks and training for all staff providing I/DD services. Providers must submit a National Criminal Background Check to DDA.

Once contracted, agency staff must complete online orientation within 30 calendar days. Additional pre-service and early-service (30/60 day) training is required through DDA's online learning management system.

7. Documentation, Policies and Records

Providers must submit comprehensive policy documentation during the credentialing process. DDA provides sample policies and review guidelines to assist applicants.

Required policies include those for Criminal Background Checks, Electronic Visit Verification (EVV), and Reportable Event Management (REM).

8. Billing, Rates and Claims

Billing for I/DD services is managed through TennCare and the contracted MCOs. DDA publishes available service rates for its programs, including Katie Beckett.

Providers must use Electronic Visit Verification (EVV) for applicable services. Therap is commonly used for billing and documentation in Tennessee.

9. Approval Sequence and Timeline

The credentialing process begins with submitting the application via email to DDA. DDA will send a confirmation email within two business days of receipt.

Providers are advised to allow 30 calendar days before requesting a status update. Completed applications are reviewed by the Provider Credentialing Committee (PCC), which meets monthly.

10. Common Denials and Survey Findings

Applications can be delayed or denied if instructions are not followed precisely. A common issue is failing to properly label uploaded documents or not using the correct subject line format in the submission email.

DDA reserves the right to revoke approval if there is evidence of material misrepresentation or falsification of information on the application.

11. Key Contacts and Resources

The DDA Office of Business Services and Provider Development are the primary contacts for prospective providers. The DDA website hosts all necessary forms, attachments, and training resources.

Providers should regularly check the 'Become a Credentialed Provider' page for updates on forums and application requirements.

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