Occupational, Physical and Speech Therapies - Developmental Disabilities

What is it?

Adult Waiver participants are eligible for additional occupational, physical and speech therapy services of a habilitative - not a restorative - nature.  These services require prior approval.  Each of the therapies must be recommended, in writing, by the individual service planning team.  The team must document the individual's specific therapy needs and services to be provided by a licensed professional.  These therapies should be long-term, working with the individual, family members, support workers and others, not short-term, acute restorative needs.

Who is eligible to enroll?

  1. Speech therapy providers must be licensed speech/language pathologists.
  2. Occupational therapy providers must be one of the following:
    • A licensed occupational therapist.
    • A certified occupational therapy assistant under the direct supervision of a licensed therapist enrolled as a Medicaid State Plan Provider and waiver provider. The assistant is not required to enroll in the Medicaid State Plan nor the waiver program. Services are billed by the licensed supervisor.
  3. Physical therapy providers must be one of the following:
    • A licensed physical therapist.
    • A licensed physical therapy assistant under the direct supervision of a licensed therapist enrolled as a Medicaid State Plan Provider and waiver provider. The assistant is not required to enroll in the Medicaid State Plan nor the waiver program. Services are billed by the licensed supervisor.

How do I enroll in the Developmental Disabilities Medicaid Waiver Program?

  1. Obtain a National Provider Identifier from the National Plan and Provider Enumeration System. 
    1. The NPI must be a Type 1- Individual.
    2. The taxonomy code should align with your credentials and services that you be providing. 
  2. Send a copy of your approval letter to:  DHS.DDDMedProv@illinois.gov.
  3. Create an IMPACT account on the IMPACT login page.  Please use the Single Sign-On ID PowerPoint Presentation found on the IMPACT Presentations and Materials page on the HFS website to complete this step. 
  4. When the Single Sign-On ID has been approved, return to the IMPACT login page and log into your account.  On the IMPACT home page there will be a blue IMPACT hyperlink located under the 4 green boxes.  Click on the IMPACT hyperlink.
  5. Click on NEW ENROLLMENT. 
    1. On the next screen, select the Enrollment Type: 
      • Individual/Sole Proprietor
      • Regular Individual/Sole Proprietor or Rendering/Servicing Provider
    2. On the Basic Information page, select the applicant type Rendering/Servicing Only. 
    3. Please use the Individual Sole Proprietor PowerPoint Presentation found on the IMPACT Presentations and Materials page to complete the application as a Rendering/Servicing Only applicant type. step. IMPACT application must includes the following information:
      1. Add Specialty:  Therapist; Occupational/Physical Therapist/Speech Language Pathologist; No Subspecialty
      2. Associate Provider:
        1. DDD Billing Provide ID number 7094718
        2. Employer's NPI or IMPACT Provider ID.
      3. Associate MCO Plan: DDD MCO Plan ID number 3000006.
  6. Send an email to DHS.DDDMedProv@illinois.gov to notify DHS, Division of Developmental Disabilities that your application has been submitted for state review
  7. Complete a Payee Designation/Authorization form (IL462-1180) to authorize the company that you are working for to submit the billing and receive the payment for the services you provide.
  8. You will receive an email notification from the IMPACT system when your provider enrollment application has been approved.  You may begin providing services at that time.