How to Start An IDD Waiver Provider in Tennessee (2026): License, Medicaid Enrollment & Rates

Licensing

Tennessee idd waiver provider license

Tennessee requires a Department of Disability and Aging (DDA) provider credentialing and contract (plus any service-specific license listed in the service definitions) from Tennessee Department of Disability and Aging (DDA, formerly DIDD); MCOs (Wellpoint, BlueCare, UnitedHealthcare) contract for ECF CHOICES to operate an IDD waiver provider. Processing time: DDA confirms receipt within two business days; applicants should allow 30 calendar days before asking for status.

License required: Yes
License: Department of Disability and Aging (DDA) provider credentialing and contract (plus any service-specific license listed in the service definitions)
Issuing agency: Tennessee Department of Disability and Aging (DDA, formerly DIDD); MCOs (Wellpoint, BlueCare, UnitedHealthcare) contract for ECF CHOICES
Processing time: DDA confirms receipt within two business days; applicants should allow 30 calendar days before asking for status.

How to apply

Steps to get licensed in Tennessee

In order, as the licensing agency describes the process.

Choose program(s) (1915(c) waivers, ECF CHOICES, Katie Beckett), services, levels and regions, and review each service definition and license requirement
Complete the New Provider Credentialing Application (separate application per NPI/tax ID)
Email it with labeled attachments (TN business license, disclosure form, W-9/IRS 147c, service-specific documents) to the DDA provider application mailbox, noting organization name and region
Complete DDA credentialing and contracting; ECF CHOICES providers also contract with the MCOs

Documents

What you need to submit

5 documents listed by the licensing agency.

Document
New Provider Credentialing Application
Tennessee state and/or county business license
Disclosure form

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Medicaid

Enrolling as a Tennessee Medicaid provider

Program: TennCare (Division of TennCare, Tennessee)
Enrollment portal: TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers
Application fee: Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. TennCare's registration pages do not list a separate state fee.
Fingerprinting: Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. TennCare's registration pages do not describe a separate state fingerprint process.
Site visit: Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. TennCare's registration pages do not describe a separate state site visit process.
Revalidation: Every TennCare provider enrollment must be revalidated every 3 years, more often than the federal 5-year minimum. Submitting any update in the enrollment portal resets the due date. Groups and entities see the due date at the top of their enrollment. Individual providers revalidate by submitting their Data Spring (CAQH ProView) application.

Full Tennessee Medicaid enrollment guide →

Certificate of need

Does Tennessee require a certificate of need?

CON program: Yes
Program: Certificate of Need
Agency: Tennessee Health Facilities Commission (HFC)
Services covered: hospitals
nursing homes (and nursing home bed increases beyond the lesser of 10 beds or 10% once every 3 years)
ambulatory surgical treatment centers
home care organizations (home health and hospice)
residential hospice
outpatient diagnostic centers
rehabilitation facilities
nonresidential substitution-based opiate treatment centers
open heart surgery, organ transplantation, cardiac catheterization, linear accelerators
MRI/PET initiation in counties of 175,000 or fewer; pediatric MRI in larger counties
bed redistribution/relocation, facility relocation, hospital satellite EDs and satellite inpatient facilities

Tennessee certificate of need details →

EVV

Electronic visit verification in Tennessee

Model: MCO-chosen
State vendor: Sandata (BlueCare); CareBridge (Wellpoint, UnitedHealthcare); Therap (DDA waiver services)
Services in scope: personal care (CHOICES, ECF CHOICES)
attendant care
1915(c) waiver services
private duty nursing
home health
Alternate EVV allowed: Yes
Program: https://www.tn.gov/content/dam/tn/tenncare/documents/EVVMemoToMCOsAndHHAProviders2023.pdf

Tennessee EVV requirements →

Labor

Tennessee wage floor

State minimum wage: $7.25 an hour
Effective: 2009-07-24
Scheduled increases: No scheduled change found in the official sources reviewed.
HCBS 80/20 rule: Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Market

Tennessee market size

Counts from federal public files: NPPES (active organization NPIs), CMS Care Compare and CMS Medicaid enrollment.

Intellectual/developmental disability residential facilities — active organization NPIs (NPPES): 472 (as of Sep 13, 2026)
Total Medicaid and CHIP enrollment (latest reported month): 1,384,007 (as of Jun 1, 2026)

Rates

What Tennessee Medicaid pays

Intellectual & developmental disabilities: published Tennessee fee-for-service rates, each linked to its source.

Service	Code	Tennessee rate	Per hour	Rank
In-home and community living supports (IDD)Agency provider	H2025	$5.79per 15 min	$23.16	20 of 29
Community integration / community access (IDD)Agency provider	T2021	$6.10per 15 min	$24.40	15 of 22
Day habilitation / day program (IDD)Agency provider	T2021	$6.10per 15 min	$24.40	15 of 32
Prevocational servicesAgency provider	T2015	$18.96per hour	$18.96	14 of 28
Residential habilitation / group home supportsAgency provider	T2033	$247.12per day	—	19 of 31

All Tennessee IDD / waiver Medicaid rates, ranked →

Waivers

Tennessee HCBS waivers

Medicaid home and community-based services programs that may pay for this service.

TN Comprehensive Aggregate Cap Home and Community Based Services (CAC) Waiver (1915(c))
TN Self-Determination Waiver Program (1915(c))
TN Statewide Home and Community Based Services Waiver (1915(c))
TennCare III (subsumes TennCare II) (1115)

Tennessee waivers and waiting lists →

FAQ

Frequently asked questions

Do you need a license to start an IDD waiver provider in Tennessee?

Tennessee requires a Department of Disability and Aging (DDA) provider credentialing and contract (plus any service-specific license listed in the service definitions) from Tennessee Department of Disability and Aging (DDA, formerly DIDD); MCOs (Wellpoint, BlueCare, UnitedHealthcare) contract for ECF CHOICES to operate an IDD waiver provider. Processing time: DDA confirms receipt within two business days; applicants should allow 30 calendar days before asking for status.

How long does it take to get licensed in Tennessee?

DDA confirms receipt within two business days; applicants should allow 30 calendar days before asking for status.

Does Tennessee require a certificate of need for an IDD waiver provider?

Tennessee has a certificate of need program covering: hospitals, nursing homes (and nursing home bed increases beyond the lesser of 10 beds or 10% once every 3 years), ambulatory surgical treatment centers, home care organizations (home health and hospice), residential hospice, outpatient diagnostic centers, rehabilitation facilities, nonresidential substitution-based opiate treatment centers, open heart surgery, organ transplantation, cardiac catheterization, linear accelerators, MRI/PET initiation in counties of 175,000 or fewer; pediatric MRI in larger counties, bed redistribution/relocation, facility relocation, hospital satellite EDs and satellite inpatient facilities. Check whether your service is on that list.

How do you become a Medicaid provider in Tennessee?

Enroll through TennCare Provider Registration portal, plus Data Spring (formerly CAQH ProView) for individual providers (https://www.tn.gov/tenncare/providers/provider-registration/how-to-apply.html).

What does Tennessee Medicaid pay a IDD waiver provider?

Tennessee Medicaid pays $5.79 per 15 min for in-home and community living supports (idd), effective Jul 1, 2025, ranking 20 of 29 states.

How to start an IDD waiver provider in Tennessee