Providers certified to deliver Medicaid Services are assigned a Medicaid number necessary to obtain federal reimbursement.
Initial Certification for Medicaid Funded Services
If you are interested in being a certified Medicaid waiver provider, you must complete all of the following standard Medicaid enrollment forms for the waiver service you wish to be certified to provide. In the application itself are instructions for completion of the application and required information that must be submitted with your application as documentation of meeting certification standards.
If you are a “new” provider or organization applying to become a Medicaid provider with the District of Columbia, complete the Medical Assistance Medicaid Enrollment Form, titled
DCMED-4000* and submit supporting documentation per the instructions and reflecting the specific requirements for the waiver services you are requesting to provide. Each waiver service is listed on the DCMED-4000 and requirements are contained in the Rules. Rules can be found by selecting the specific service in
Waiver service descriptions and following the links to each Rule. Select
Medicaid Waiver Application Approval Process for more information on the application process.
