Children's Long-Term Support (CLTS) Waiver Provider Registry

Are you interested in delivering your services to help children with disabilities?

Approximately 7,600 children with disabilities are currently being served through the CLTS Waiver Program. That number is projected to grow 30 percent by the end of 2018. Many families are looking for local businesses and individuals to provide services that help their children increase or maintain their daily capabilities at home, at school, or in the community.

The CLTS Waiver Program supports the needs of children with disabilities with a wide array of services delivered both in the home and out in the community.

Registering with the Department of Health Services (DHS) is the first step in becoming an approved provider of CLTS waiver services.

For more information, see the CLTS Service Descriptions and Requirements for Qualified Providers (PDF).

New! DHS is launching a searchable online CLTS Waiver Provider Directory that is targeted to be available to the general public in November 2018. Sign up for the CLTS provider email list to receive updates about this and other provider-related information.

How to Register

All new and current CLTS waiver providers must complete the steps below to register. Current providers must register by October 31, 2018. DHS requires providers to re-register every four years.

Note: If you are a direct care employee of a provider agency or submit time sheets to a fiscal agent, do not complete this registration process.

Step 1: Complete, sign, and scan the appropriate CLTS Medicaid Waiver Provider Agreement (see the Program Resources tab). You will upload this form during the online registration process.

Step 2: Gather your business information (business name as reported to the IRS, tax ID number, and national provider identifier (NPI) if you are a county waiver agency or deliver medical services—see the CLTS Benefit Package (PDF) to determine if your services require you to have an NPI).

Step 3: Fill out the online Children's Long-Term Support Waiver Provider Registry, F-02341A. You will receive a confirmation email upon successful registration.

Step 4: After your successful registration, DHS will share your information with the county waiver agency in the area you wish to provide services.

Step 5: Contact the county waiver agency(ies) where you are interesting in delivering services. They will manage the rest of the provider approval process, including conducting screening activities, verifying your credentials, issuing any contracts or agreements, claims processing forms, and authorizing services.

Note: Filling out the CLTS Waiver Provider Registry does not mean you are approved as a qualified provider authorized to deliver services. The county waiver agency must approve your provider qualification status before you are authorized to deliver services.

Questions? Please email the DHS Provider Registry.

Who to Contact

See a list of County Waiver Agency contacts.

Questions? Please email the DHS Provider Registry.

Program Resources

Medicaid Waiver Provider Agreement forms

When you register, you will need to upload a completed Medicaid Waiver Provider Agreement form to the Provider Registry. Choose the appropriate form from the list below.

Payment Information

DHS contracts with Wisconsin Physicians Service (WPS) as the CLTS third-party administrator (TPA) claims processing vendor. WPS processes and issues payments to providers, reports claim data to DHS, and recovers overpayments per federal regulations. Once you have been approved as a provider and authorized to deliver services, you will submit claims to WPS for payment.

DHS is currently developing statewide payment rates for most CLTS waiver services. Providers will be paid based on these rates starting in January 2019. You can find out more at the CLTS Waiver Service Rates Initiative page.


Last Revised: November 6, 2018