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Wisconsin - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Wisconsin Department of Health Services (DHS) funds Personal Emergency Response System (PERS) equipment and monitoring through the Children's Long-Term Support (CLTS) waiver and adult Family Care programs. Providers must secure authorization from a County Waiver Agency (CWA) or Managed Care Organization (MCO) before delivering any billable service to a participant.

Approval requires registering as a non-medical vendor through the ForwardHealth portal and the CLTS Provider Registry, rather than obtaining a traditional healthcare facility license. Applicants must hold a valid Federal Employer Identification Number (EIN) and submit commercial liability insurance documentation directly to the state claims processor prior to enrollment.

1. Service Definition and Scope

In Wisconsin, a Personal Emergency Response System (PERS) is defined as an electronic device used by a participant to call for help in an emergency, connecting them to a 24-hour response center. The service includes the installation of the equipment, monthly monitoring, and ongoing maintenance.

This service is strictly non-habilitative and is limited to individuals who live alone or are at significant risk of falls or medical emergencies. It cannot be authorized for participants residing in provider-owned or controlled settings unless a specific transition plan is in place.

2. Regulatory and Oversight Agencies

The Wisconsin Department of Health Services (DHS) is the primary state agency responsible for overseeing Medicaid waiver programs, including CLTS and Family Care. DHS manages provider enrollment, sets service standards, and maintains the public provider directories.

ForwardHealth is the state's Medicaid Management Information System (MMIS) and portal, handling all claims, provider agreements, and enrollment verifications. County Waiver Agencies (CWAs) and Managed Care Organizations (MCOs) handle local oversight and participant authorizations.

3. Gatekeeping Prerequisites: Who Can Even Apply

Wisconsin does not require a Certificate of Need (CON) or a competitive Request for Proposals (RFP) process to become a PERS provider. The network is generally open to any qualified business entity that meets the state's vendor requirements.

However, providers cannot bill for services simply by enrolling; they must obtain a specific service authorization from a CWA or MCO for each participant. Additionally, providers must have a valid Tax ID Number (TIN) or Employer Identification Number (EIN) established with the IRS before initiating the enrollment application.

4. Licensure and Certification Requirements

Wisconsin does not issue a distinct state healthcare facility license for Personal Emergency Response System providers. Because PERS is considered an equipment and monitoring service rather than direct medical care, providers are approved through Medicaid enrollment rather than traditional licensure.

Providers must instead meet the specific qualification criteria outlined in the Medicaid Home and Community-Based Services (HCBS) Manual for the CLTS Program or the Family Care contract. This includes maintaining active commercial liability insurance and adhering to general business regulations.

5. Medicaid Provider Enrollment

To bill Wisconsin Medicaid, PERS providers must enroll through the ForwardHealth Portal and, if serving children, the CLTS Provider Registry. The process requires submitting business information, signing the Wisconsin Medicaid Provider Agreement, and passing a basic state screening.

Providers delivering medical services or equipment are typically required to obtain a National Provider Identifier (NPI). The enrollment process is entirely digital, and approved providers are added to the public CLTS Provider Directory.

6. Staffing, Training and Background Checks

While PERS is primarily an equipment service, any staff members who enter a participant's home to install or maintain the device must pass Wisconsin caregiver background checks. This ensures the safety of vulnerable adults and children receiving waiver services.

Staff must also be trained on how to instruct participants in using the PERS device. The response center staff must be trained to handle emergency calls and maintain an updated list of participant emergency contacts.

7. Documentation, Policies and Records

PERS providers must maintain strict documentation to support their Medicaid claims and ensure service quality. This includes keeping records of equipment installation, monthly testing logs, and updated emergency contact lists for each participant.

Providers are also required to obtain the participant's or authorized representative's signature verifying receipt of the PERS unit. Insurance documentation must be kept current, and any changes to policies must be reported to ForwardHealth immediately.

8. Billing, Rates and Claims

PERS services in Wisconsin are typically reimbursed using a two-part structure: a one-time installation fee and a recurring monthly rental or monitoring fee. Claims are submitted through the ForwardHealth MMIS using specific HCPCS procedure codes designated in the participant's authorization.

Providers cannot charge Medicaid more than their usual and customary rate charged to the general public. All services must be explicitly authorized in the participant's Person-Centered Plan (PCP) and fall within their annual individual budget amount.

9. Approval Sequence and Timeline

The approval sequence begins with gathering business documentation and applying through the CLTS Provider Registry or ForwardHealth Portal. State review of the enrollment application typically takes 30 to 60 days, provided all insurance and tax documents are accurate.

Once enrolled, the provider must proactively contact County Waiver Agencies to notify them of their availability. The final step is receiving a service authorization from the CWA for a specific participant, which must occur before any equipment is installed or billed.

10. Common Denials and Survey Findings

Enrollment applications are frequently delayed or denied due to incomplete insurance documentation. Wisconsin Medicaid requires a copy of the actual commercial insurance policy and a receipt of payment; standard certificates of insurance are often rejected.

During audits or claims reviews, common findings include billing for services without a valid CWA authorization, failing to document monthly equipment tests, or lacking the required participant signature verifying receipt of the PERS device.

11. Key Contacts and Resources

Providers should utilize the official state portals for all enrollment and billing activities. The CLTS Provider Contact Center is available to assist with registry questions and provider type identification.

For local authorizations, providers must maintain contact with the specific County Waiver Agencies operating in their target service areas.

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