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

Licensing

South Dakota idd waiver provider license

South Dakota requires a Community Services Provider (CSP) or Community Support Provider (SP) certification under ARSD 46:11, plus provider agreements with DDD and DSS from South Dakota Department of Human Services, Division of Developmental Disabilities (DDD); South Dakota Medicaid (Department of Social Services) provider agreement to operate an IDD waiver provider.

License required: Yes
License: Community Services Provider (CSP) or Community Support Provider (SP) certification under ARSD 46:11, plus provider agreements with DDD and DSS
Issuing agency: South Dakota Department of Human Services, Division of Developmental Disabilities (DDD); South Dakota Medicaid (Department of Social Services) provider agreement
Accreditation: Required: accreditation by a national quality assurance organization designated by DDD (CHOICES and Family Support 360 waivers).
Regulation: ARSD 46:11 (incl. 46:11:02 certification procedures and 46:11:04:04 six-year records retention)

How to apply

Steps to get licensed in South Dakota

In order, as the licensing agency describes the process.

Obtain CSP or SP certification from DHS under ARSD 46:11 (procedures in ARSD 46:11:02)
Obtain accreditation from a national quality assurance organization designated by DDD
Sign a provider agreement with DDD
Enroll in South Dakota Medicaid and sign a provider agreement with the Department of Social Services

Medicaid

Enrolling as a South Dakota Medicaid provider

Program: South Dakota Medicaid (Department of Social Services, Division of Medical Services)
Enrollment portal: South Dakota Medicaid Provider Enrollment (PE) Portal
Application fee: SD Medicaid's enrollment page says no application fee is charged. (Federal rule 42 CFR 455.460 allows the fee; CMS set it at $750 for 2026.)
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 SD DSS enrollment page we could reach does not describe a separate state fingerprint process (its maintenance/revalidation page returned an error).
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 SD DSS enrollment page we could reach does not describe a separate state site visit process.
Revalidation: Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. SD Medicaid ran a portal-wide revalidation when the PE Portal launched in 2021 (due June 7, 2021). Records that could not be revalidated were terminated, and existing providers did not have to re-sign provider agreements.

Full South Dakota Medicaid enrollment guide →

Certificate of need

Does South Dakota require a certificate of need?

CON program: No
Agency: South Dakota Department of Health (nursing facility bed moratorium and redistribution)
Moratoria: A nursing facility bed moratorium dates to 1988 and was extended indefinitely in 2005 (SDCL 34-12-35.4). The Department of Health may let a facility add beds or approve a new nursing facility only by redistributing beds from closed facilities or voluntarily surrendered beds, so the statewide total cannot exceed the 2005 level. Redistribution runs through periodic requests for proposals (held most years from 2013 to 2025), and the department reports annually to the Legislature on the need for more beds (SB 6, 2017).

South Dakota certificate of need details →

EVV

Electronic visit verification in South Dakota

Model: hybrid
State vendor: Therap
Services in scope: personal care
HOPE waiver services
self-directed personal care
home health
private duty nursing
Alternate EVV allowed: Yes
Program: https://dss.sd.gov/docs/medicaid/providers/billingmanuals/General/Electronic_Visit_Verification.pdf

South Dakota EVV requirements →

Labor

South Dakota wage floor

State minimum wage: $11.85 an hour
Effective: 2026-01-01
Scheduled increases: Adjusted each January 1 by CPI; the state publishes the new rate by October 15. The 2027 rate was not yet found.
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

South Dakota 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): 14 (as of Sep 13, 2026)
Total Medicaid and CHIP enrollment (latest reported month): 138,321 (as of Jun 1, 2026)

Rates

What South Dakota Medicaid pays

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

Service	Code	South Dakota rate	Per hour	Rank
In-home and community living supports (IDD)Agency provider	T2017	$17.32per 15 min	$69.28	2 of 29
Day habilitation / day program (IDD)Agency provider	T2020	$15.78per hour	$15.78	26 of 32
Prevocational servicesAgency provider	T2019	$9.65per hour	$9.65	23 of 28
Residential habilitation / group home supportsAgency provider	T2016	$292.61per day	—	15 of 31
Supported employment (job coaching)Agency provider	T2019	$18.25per 15 min	$73.00	6 of 39

All South Dakota IDD / waiver Medicaid rates, ranked →

Waivers

South Dakota HCBS waivers

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

SD Assistive Daily Living Services Waiver (1915(c))
SD CHOICES Waiver (1915(c))
SD Family Support 360 Waiver (1915(c))
SD Home and Community-Based Options and Person-Centered Excellence (HOPE) Waiver (1915(c))

South Dakota waivers and waiting lists →

FAQ

Frequently asked questions

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

South Dakota requires a Community Services Provider (CSP) or Community Support Provider (SP) certification under ARSD 46:11, plus provider agreements with DDD and DSS from South Dakota Department of Human Services, Division of Developmental Disabilities (DDD); South Dakota Medicaid (Department of Social Services) provider agreement to operate an IDD waiver provider.

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

No. South Dakota has no certificate of need program.

How do you become a Medicaid provider in South Dakota?

Enroll through South Dakota Medicaid Provider Enrollment (PE) Portal (https://dss.sd.gov/medicaid/providers/enrollment/enrollment.aspx).

What does South Dakota Medicaid pay a IDD waiver provider?

South Dakota Medicaid pays $17.32 per 15 min for in-home and community living supports (idd), effective Jun 1, 2026, ranking 2 of 29 states.

How to start an IDD waiver provider in South Dakota