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

Last reviewed: 2026-09-10

Washington funds Assistive Technology through the Developmental Disabilities Administration (DDA) Individual and Family Services (IFS), Basic Plus, Core, and Community Protection waivers, as well as the Aging and Long-Term Support Administration (ALTSA) COPES waiver. Approval requires a direct contract with the Department of Social and Health Services (DSHS) and enrollment as a non-billing, billing, or servicing provider in the Health Care Authority's ProviderOne MMIS system.

The state does not require a distinct facility license from the Department of Health (DOH) to operate as an Assistive Technology vendor. Instead, the structural precondition for application acceptance is holding an active Washington State Unified Business Identifier (UBI) and, if providing clinical evaluations, holding the corresponding active DOH professional license (such as Occupational Therapy or Speech-Language Pathology) before submitting the DSHS contract packet.

1. Service Definition and Scope

In Washington, Assistive Technology encompasses items, equipment, or product systems used to increase, maintain, or improve functional capabilities of waiver participants, as well as the evaluation and training required to use them. The service is designed to reduce the participant's reliance on paid personal care staff or prevent institutionalization.

The scope includes commercial off-the-shelf devices, customized equipment, and specialized assessments. It explicitly excludes items that are covered under the Medicaid State Plan as Durable Medical Equipment (DME), meaning waiver funds are the payer of last resort.

• Service Components: Evaluation of the participant's needs in their customary environment, purchasing or leasing devices, and training for the participant or their caregivers.
• Exclusions: Items covered by Apple Health (Medicaid State Plan) DME benefits, experimental items, or items solely for recreational purposes.
• Waiver Authorities: DDA Basic Plus, Core, Community Protection, IFS, and ALTSA COPES waivers.
• Limit: DDA waivers typically cap Assistive Technology and related specialized equipment within the client's annual allocation, requiring prior approval for items exceeding specific dollar thresholds.

2. Regulatory and Oversight Agencies

Assistive Technology providers are overseen by the divisions managing the specific waivers they serve. DSHS handles the contracting and policy enforcement, while the Health Care Authority (HCA) manages the Medicaid enrollment and payment infrastructure.

Because this is a vendor-level service rather than a licensed facility type, oversight is primarily contract-based rather than survey-based, managed through DSHS regional offices.

• Department of Social and Health Services (DSHS) DDA: Manages developmental disability waivers and issues provider contracts. https://www.dshs.wa.gov/dda
• Department of Social and Health Services (DSHS) ALTSA: Manages aging and physical disability waivers. https://www.dshs.wa.gov/altsa
• Washington State Health Care Authority (HCA): Administers Apple Health and the ProviderOne MMIS. https://www.hca.wa.gov
• Department of Health (DOH): Licenses individual clinicians (OT, PT, SLP) who perform AT evaluations. https://doh.wa.gov

3. Gatekeeping Prerequisites: Who Can Even Apply

Washington does not impose Certificate of Need (CON) requirements, closed network moratoria, or mandatory managed care affiliations for fee-for-service waiver Assistive Technology vendors. The state operates an open enrollment process for qualified vendors.

There are no mandatory subcontracting requirements under a designated network entity. However, an applicant must possess a valid Washington State business license and UBI number before DSHS will process a Core Provider Agreement.

• Business Registration: Must hold an active Washington State Unified Business Identifier (UBI) from the Department of Revenue.
• Professional Licensure: If the applicant is providing the evaluation component, they must hold an active, unencumbered DOH license (e.g., Occupational Therapist) prior to application.
• Network Status: Open enrollment; no RFP or competitive procurement is required to become a standard waiver AT vendor.
• Medicaid State Plan Exhaustion: Providers must be able to demonstrate that the requested items are not covered by the State Plan before billing the waiver.

4. Licensure and Certification Requirements

Washington does not issue a specific "Assistive Technology Agency" license. Providers operate as contracted vendors. The credentialing requirements depend entirely on the specific component of the service being delivered.

Vendors selling commercial off-the-shelf items need only standard business registration. Professionals conducting complex evaluations or customizing equipment must hold relevant state clinical licenses or national certifications.

• Evaluating Clinicians: Must hold active Washington DOH licensure as an Occupational Therapist, Physical Therapist, or Speech-Language Pathologist.
• Complex Rehab Technology: Providers customizing complex mobility devices typically must employ a RESNA-certified Assistive Technology Professional (ATP).
• General Vendors: Retailers or technology vendors providing off-the-shelf devices (e.g., tablets for communication) require no specialized health licensure.
• Out-of-State Providers: May enroll if they hold equivalent licensure in their home state and meet Washington's business registration requirements for out-of-state vendors.

5. Medicaid Provider Enrollment

All waiver providers must enroll in the Health Care Authority's ProviderOne system. For Assistive Technology, this typically involves enrolling as a non-traditional provider or DME vendor, depending on the exact services offered.

Enrollment requires a signed Core Provider Agreement with DSHS, which is then linked to the ProviderOne profile to authorize billing for waiver-specific procedure codes.

• System: ProviderOne is the mandatory MMIS portal for all enrollment and claims. https://www.providerone.wa.gov
• Agreement: Must sign the DSHS Core Provider Agreement (Form 10-021).
• Taxonomy: Providers must select the appropriate taxonomy code, often 332B00000X (Durable Medical Equipment & Medical Supplies) or a specific therapy taxonomy.
• Application Fee: Federally mandated application fee applies to institutional providers and DME vendors unless waived by Medicare enrollment.

6. Staffing, Training and Background Checks

Because Assistive Technology is primarily a goods-and-equipment service, the extensive 75-hour Home Care Aide training required for direct care staff does not apply to AT vendors. However, any staff interacting directly with vulnerable adults must clear state background checks.

Background checks are processed through the DSHS Background Check Central Unit (BCCU) prior to any unsupervised contact with waiver participants.

• Background Checks: Mandatory Washington State Patrol and federal fingerprint checks via DSHS BCCU for staff with direct client contact.
• Clinical Staff: Must maintain continuing education units (CEUs) as required by their specific DOH professional license.
• Vendor Staff: No mandated state training hours for retail or delivery staff, provided they do not perform direct personal care.
• Delegation: AT staff cannot perform nursing tasks or medication administration; these require specific RN delegation and Home Care Aide certification.

7. Documentation, Policies and Records

DSHS requires AT providers to maintain records justifying the necessity, delivery, and cost of the technology. This documentation is subject to audit by DSHS and HCA.

Providers must retain all records for a minimum of six years from the date of service delivery, in accordance with the Core Provider Agreement.

• Evaluation Records: Written assessments detailing the client's functional deficit and how the specific technology mitigates it.
• Proof of Delivery: Signed delivery tickets or shipping receipts confirming the client received the device.
• Cost Documentation: Invoices or MSRP sheets demonstrating the actual cost of the item, required for manual pricing of miscellaneous codes.
• State Plan Denial: Documentation (such as an EOB or policy manual excerpt) proving the item is not covered under the Medicaid State Plan.

8. Billing, Rates and Claims

Assistive Technology is billed through ProviderOne using specific HCPCS codes authorized on the client's Person-Centered Service Plan. Many AT items do not have a fixed fee schedule rate and are manually priced based on invoice cost.

Prior authorization from the DDA or ALTSA case manager is strictly required before purchasing or delivering any equipment. Claims submitted without a matching authorization in ProviderOne will deny.

• Authorization: Case managers issue a Service Authorization in ProviderOne detailing the approved codes, units, and maximum dollar amount.
• Pricing: Often reimbursed at invoice cost plus a state-defined percentage markup, or MSRP minus a percentage, depending on the item.
• Common Codes: T2028 (Specialized supply, not otherwise specified) or specific DME codes modified for waiver use.
• Claim Submission: Claims are submitted electronically via the ProviderOne portal or via 837P EDI transactions.

9. Approval Sequence and Timeline

The approval sequence begins with obtaining necessary business and professional licenses, followed by submitting the DSHS contract application. Once DSHS approves the contract, the provider completes the ProviderOne enrollment.

The entire process typically takes 60 to 90 days, assuming the provider already holds the necessary DOH clinical licenses or RESNA certifications.

• Step 1: Obtain Washington UBI and any required DOH professional licenses (1-4 weeks).
• Step 2: Submit DSHS Core Provider Agreement and AT-specific contract exhibits (30-45 days for DSHS review).
• Step 3: Complete BCCU background checks for applicable staff (1-2 weeks, concurrent).
• Step 4: Submit ProviderOne enrollment application linking the DSHS contract (30 days for HCA processing).

10. Common Denials and Survey Findings

Because AT providers are not surveyed like residential facilities, compliance issues usually arise during claims audits or contract renewals. The most frequent issue is billing for items that should have been routed through the Medicaid State Plan.

Contract applications are most commonly delayed due to incomplete background check forms or mismatched tax identification information between the IRS, DSHS, and ProviderOne.

• Claim Denial: Billing before the case manager has entered the Service Authorization into ProviderOne.
• Audit Finding: Failure to maintain signed proof of delivery for equipment.
• Audit Finding: Supplying an item that is covered by Apple Health DME benefits without first receiving a formal denial from the State Plan.
• Enrollment Delay: Submitting a W-9 that does not exactly match the legal entity name registered with the Washington Secretary of State.

11. Key Contacts and Resources

Providers should rely on the DSHS Developmental Disabilities Administration and the Health Care Authority for official manuals, billing guides, and contract exhibits.

The ProviderOne portal contains the most current billing instructions and fee schedules for waiver services.

• DDA Provider Resources: Official contract exhibits and policy manuals. https://www.dshs.wa.gov/dda/providers-and-advocates
• ProviderOne Portal: Medicaid enrollment and claims system. https://www.providerone.wa.gov
• HCA Provider Enrollment: Guidance on MMIS registration. https://www.hca.wa.gov/billers-providers-partners/apple-health-medicaid-providers/enroll-provider
• DSHS Background Check Central Unit (BCCU): Processing for required staff clearances. https://www.dshs.wa.gov/ffa/background-check-central-unit

See all Washington services · Washington Medicaid consulting · book a consultation.