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Provider Enrollment
Provider Enrollment > Nursing Home Transition and Diversion Waiver Program (NHTD)


To enroll a Nursing Home Transition and Diversion Waiver Program in New York State Medicaid, please contact NHTD Waiver Management Staff for the Regional Resource Development Center(s) in the region(s) in which you would like to provide waiver services at (518) 486-3154.

Please Note: Existing providers have the option of billing new programs or services with an NPI already enrolled with the NY State Medicaid Program or an NPI unknown to NYS Medicaid. To report an unknown NPI, an enrollment application will be sent to you to complete and return to Medicaid's fiscal agent, Computer Sciences Corportion (CSC). Adding a new service or program to an enrolled NPI may require completion of other enrollment documents. Please contact the Rate Based Provider Bureau at (518) 474-3575, option 4 or (800) 342-3005, option 4 if you have any questions regarding these NPI options.
Enrollment Checklist
 

To expedite the enrollment process, you can begin collecting copies of documents that you will need to include when you submit the completed enrollment form:

A copy of your FEIN documentation showing both the name and number preprinted (a W-9 is not sufficient for enrollment purposes).

 

A list of the facility's or program's owners and/or Board of Directors with addresses.

 

A copy of your NPI assignment notification (only if enrolling professional(Physician, NHTD Services, etc)).

 

Potential providers who want to provide Home and Community Support Services need to have a Licensed Home Care Service Agency (LHCSA) and Certified Home Health Agency (CHHA).

 

Copies of contracts with the Local Department of Social Services (LDSS).

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