This document summarizes the step-by-step process an organization must complete to become an enrolled CHW agency through South Dakota Medicaid.
The following link provides the fee schedule for CHW services offered both individually and in a group setting.
Medicaid’s Billing and Policy Manual provides a comprehensive overview of CHW reimbursement including scope of work, reimbursement rates, limitations, etc. To access this manual, click the button below, scroll down to Professional Provider Manuals and click Community Health Worker Services.
To enroll as a CHW Agency with South Dakota Medicaid, organizations will need to register for an NPI Type 2 number through the National Plan & Provider Enumeration System. Organizations should apply for this early on in the enrollment process as it can take up to 6 weeks to obtain an NPI number.
The following form can be used as a draft for organizations to use to ensure the appropriate information is prepared before completing the NPI enrollment online. Please Note: CHW organizations need to enroll to obtain a new and unique Type 2 NPI number. CHW organizations should ONLY use the taxonomy code: 172V00000X for this new Type 2 NPI number specific to their CHW program. Please Note: As you select the CHW Taxonomy code of 172V00000X, the Multi-Specialty Group Code or the Single-Specialty Group Code of 193200000X may also show under your NPI number specific to your CHW program. The CHW taxonomy code should always be primary.