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

Licensing

Oregon idd waiver provider license

Oregon requires a I/DD Medicaid agency certification with service endorsements; 24-hour residential homes and host homes also need a site license from Oregon Department of Human Services, Office of Developmental Disabilities Services (ODDS) - I/DD Licensing to operate an IDD waiver provider. Fee: $500.

License required: Yes
License: I/DD Medicaid agency certification with service endorsements; 24-hour residential homes and host homes also need a site license
Issuing agency: Oregon Department of Human Services, Office of Developmental Disabilities Services (ODDS) - I/DD Licensing
Fee: $500
Fee details: $500 Medicaid agency certification plus endorsement fees: $100 each for Employment Services, Supported Living, Community Living Supports (standard or employer model); $0 for 24-hour residential, host homes, direct nursing and positive behavior support endorsements. 24-hour residential site license: initial $75 per capacity slot in Clackamas, Multnomah or Washington counties, $50 per slot elsewhere. All fees nonrefundable.
Renewal: Every 2 years · Certification and endorsements renew every two years at the same fees; 24-hour residential license renewal $50 per capacity slot; host home renewal $50 per home.
Regulation: OAR 411-323 (agency certification and endorsement)

How to apply

Steps to get licensed in Oregon

In order, as the licensing agency describes the process.

Choose services and endorsements and confirm local need with the community developmental disabilities program (CDDP) or brokerage
Make sure the executive director meets OAR 411-323 qualifications
Pass the Medicaid Agency Orientation (MAO) through an approved vendor
Pay certification and endorsement fees through the Medicaid agency payment portal
Submit the online agency and endorsement application in one session with all documents and the payment receipt
For 24-hour residential or host homes, submit a separate license application for each site
Respond to ODDS requests by the deadlines; ODDS approves and the agency enrolls as an Oregon Medicaid provider

Documents

What you need to submit

6 documents listed by the licensing agency.

Document
Executive director MAO certificate, resume with three references, background check, CPR certificate, mandatory abuse reporting trainings (adult and child)
Management agreements or ownership contracts
Business plan

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Staffing

Staffing and training requirements

Training: Medicaid Agency Orientation (MAO) for the executive director
Mandatory abuse reporting training (adults and children)

Medicaid

Enrolling as a Oregon Medicaid provider

Program: Oregon Health Plan (OHP), Oregon Health Authority (OHA)
Enrollment portal: Oregon MMIS Provider Portal (or-medicaid.gov)
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. OHA's enrollment page does 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. The OHA enrollment and revalidation 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. The OHA enrollment and revalidation pages do not describe a separate state site visit process.
Revalidation: OHA rescreens every actively enrolled provider at least once every 5 years. It mails a notice to the provider's mail-to address. The provider returns the listed forms (for organizations OHA 3972, 3974 and 3975; for payable individuals OHA 3972 and 3975; for other individuals OHP 3113 and OHA 3975) by the due date, ideally online through the MMIS Provider Portal. If the forms are not returned, participation can end under OAR 410-120-1260. A revalidation received within 30 days after inactivation is treated as a revalidation; after that it is treated as a re-enrollment.

Full Oregon Medicaid enrollment guide →

Certificate of need

Does Oregon require a certificate of need?

CON program: Yes
Program: Certificate of Need
Agency: Oregon Health Authority, Public Health Division (Certificate of Need Program)
Services covered: new hospitals
new skilled nursing or intermediate care services or facilities (long-term care), including rebuilds and bed relocations through expedited review

Oregon certificate of need details →

EVV

Electronic visit verification in Oregon

Model: hybrid
State vendor: Direct Care Innovations (OR PTC DCI) for ODHS in-home workers; none for home health agencies
Services in scope: personal care (homecare and personal support workers)
home health
Alternate EVV allowed: Yes
Program: https://www.oregon.gov/odhs/providers-partners/orptc/pages/default.aspx

Oregon EVV requirements →

Labor

Oregon wage floor

State minimum wage: $15.55 an hour
Effective: 2026-07-01
Scheduled increases: Adjusted each July 1 by CPI (US DOL); the July 2027 rates were not yet published in the sources reviewed.
Direct-care wage floor: Homecare and personal support workers paid through ODHS earn a base rate set by collective bargaining: $21.25/hour at step 1 for 2026, plus add-ons (CPR/first aid, enhanced and exceptional pay).
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

Oregon 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): 104 (as of Sep 13, 2026)
Total Medicaid and CHIP enrollment (latest reported month): 1,264,858 (as of Jun 1, 2026)

Rates

What Oregon Medicaid pays

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

Service	Code	Oregon rate	Per hour	Rank
In-home and community living supports (IDD)Agency provider		$39.08per hour	$39.08	12 of 29
Day habilitation / day program (IDD)Agency provider	OR542	$29.30per hour	$29.30	12 of 32
Prevocational servicesAgency provider	OR541	$74.31per hour	$74.31	1 of 28
Residential habilitation / group home supportsAgency provider		$503.86per day	—	4 of 31
Supported employment (job coaching)Agency provider	OR543	$32.92per hour	$32.92	25 of 39

All Oregon IDD / waiver Medicaid rates, ranked →

Waivers

Oregon HCBS waivers

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

OR Adults' HCBS Waiver (1915(c))
OR Aged and Physically Disabled Waiver (1915(c))
OR Behavioral (ICF/IDD) Model Waiver (1915(c))
OR Children's Extraordinary Needs Waiver (1915(c))
OR Children's HCBS Waiver (1915(c))
OR Medically Fragile (Hospital) Model Waiver (1915(c))
OR Medically Involved Children's Waiver (MICW) (1915(c))
Oregon Project Independence - Medicaid (1115)

Oregon waivers and waiting lists →

FAQ

Frequently asked questions

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

Oregon requires a I/DD Medicaid agency certification with service endorsements; 24-hour residential homes and host homes also need a site license from Oregon Department of Human Services, Office of Developmental Disabilities Services (ODDS) - I/DD Licensing to operate an IDD waiver provider. Fee: $500.

How much does an IDD waiver provider license cost in Oregon?

$500 Renewal: Every 2 years · Certification and endorsements renew every two years at the same fees; 24-hour residential license renewal $50 per capacity slot; host home renewal $50 per home..

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

Oregon has a certificate of need program covering: new hospitals, new skilled nursing or intermediate care services or facilities (long-term care), including rebuilds and bed relocations through expedited review. Check whether your service is on that list.

How do you become a Medicaid provider in Oregon?

Enroll through Oregon MMIS Provider Portal (or-medicaid.gov) (https://www.or-medicaid.gov/).

What does Oregon Medicaid pay a IDD waiver provider?

Oregon Medicaid pays $39.08 per hour for in-home and community living supports (idd), effective Jul 1, 2026, ranking 12 of 29 states.

How to start an IDD waiver provider in Oregon