The Department of Health Services (DHS) has contracted with a Third Party Administrator (TPA) claims processing vendor for the Children's Long-Term Support (CLTS) Waiver provider services. The DHS TPA vendor is Wisconsin Physicians Service (WPS). WPS processes and issues payments for CLTS services, collects and reports claims data, and recovers overpayments on behalf of DHS according to federal regulations.
County Waiver Agency Information
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See the following for more information related to the statewide TPA implementation:
See the following CLTS Waiver Program TPA provider information:
- IRS W-9 Form Request for Taxpayer Identification Number and Certification (PDF)
- Third Party Administration (TPA) Children's Medicaid Waivers Provider Billing and Service Information (F-00412) (Word)
- WPS CLTS Waiver Program Claims Processing
- WPS General CLTS Claim Submission Requirements (PDF)
A Note Regarding ICD-10
WPS, DHS's third party administrator for the Children's Long-Term Supports (CLTS) Waiver Program claims processing, only accepts ICD-10 medical codes for any medical service claims submitted for payment. Provider claims submitted with ICD-9 codes will not be accepted.
Non-medical providers using the ICD-9 default code of 780.99 can use the ICD-10 default code of R6889 when submitting electronically. Paper and spreadsheet claims can continue to be submitted without an ICD-10 code for non-medical services.
Additional details are available on the ForwardHealth ICD-10 Code Set Transition page.
For more information regarding the TPA claims processing, contact:
County Waiver Agencies:
DHS Children's Long-Term Supports Waiver Program:
WPS CLTS Customer Service Call Center, Monday through Friday at:
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WPS CLTS Customer Service Call Center Monday through Friday at: