Bureau of Developmental Disabilities Services (BDDS) Provider Services

BDDS new provider application process

Applications to provide Indiana’s Home and Community Based Services (HCBS) waiver services through BDDS may be made year around. All components of the new provider application packet must be completed. Once a completed application is received, the information submitted is reviewed by the provider services department. Provider applicants may receive a written Request for Information if the application components are not clear or questions exists. If the provider applicant meets the requirements of 460 IAC Article 6 and DDRS policies, the application will be moved forward as authorized to start the process of applying for enrollment with Indiana Health Coverage Programs (IHCP) (outlined below). If the application packet is not completed in its entirety, or the applicant does not meet the requirements outlined for the service(s), the application will be denied by provider services.

If an agency/individual BDDS application is denied, the agency/individual may submit one additional application within a 12 month timeframe. If a second application is also denied,12 full months must pass from the date of the last application submission before a new application will be accepted.

Please note, provider application documents submitted will not be returned to the applicant. The documentation becomes the property of the state. The mailing address for the completed application is:

Director of Provider Services
DDRS - Division of Disability and Rehabilitative Services
402 W. Washington St., RM 453, MS 18
Indianapolis, IN 46204-2243

As referenced above, becoming a BDDS waiver provider is a two part process. Once a provider application is authorized by BDDS provider services, the applicant must then apply to enroll with IHCP. To view the IHCP requirements, please reference http://www.indianamedicaid.com.

When a provider applicant receives the BDDS letter authorizing the applicant to start the IHCP enrollment process, the applicant must submit the IHCP enrollment application within 90 days of the BDDS letter of authorization. A provider applicant may obtain an IHCP provider enrollment application by downloading it from the provider enrollment page at http://www.indianamedicaid.com.

BDDS provider (potential and existing) application update

Applications for case management companies, under Indiana’s Home and Community Based Services (HCBS) waiver, are not being accepted. In addition, requests to add counties for existing case management providers are not being accepted at this time. BDDS has determined that a sufficient number of providers in this area currently exist in order to provide services under Indiana’s HCBS waiver. Please continue to check this website for updates to this status. (Effective September 2015)

BDDS new provider application packet

  1. Provider Requirements for Medicaid Home and Community Based Waiver Services  (01/13)
  2. Application For Approval to Become a Provider of BDDS Service - State Form 53869 (rev.11/10)
  3. FSSA Provider Data Form
  4. Division of Disability and Rehabilitative Services Provider Agreement State Form 55006 (06/12)
  5. W9 - Request for Taxpayer Identification Number and Certification - IRS Form (12/14)


BDDS existing providers

Survey Data