Provider Enrollment & Maintenance

The Chronic Disease Self-Management Program (CDSMP) is an evidence-based, self-management interactive program for adults that focuses on disease management skills. Its purpose is to increase confidence, physical and psychological well-being, knowledge to manage chronic conditions, and the motivation to manage challenges associated with chronic diseases including arthritis. Only providers enrolled in Medicaid as a Community Based Organization (CBO) are eligible to be reimbursed for CDSMP services delivered to Medicaid members.

CDSMP Resources:

1. Chronic Disease Self-Management Program Implementation and Fidelity Manual
2. CDSMP Program Locator

Provider Training Videos

eMedNY provides an "Introduction to Provider Enrollment" that walks providers through the steps of how to enroll as a provider of services for the NYS Medicaid program on the Provider Enrollment Guide page.

IMPORTANT: The CDSMP Recognition Attestation (Form #434902) is a requirement for all of the CDSMP service providers. Providers seeking enrollment in NYS Medicaid as a CDSMP service rmust attest it has achieved programmatic licensure based on the policies outlined in the Self-Management Resource Center (SMRC) Program Implementation and Fidelity Manual, and understands it must adhere to all of the rules, obligations, and responsibilities contained therein to be able to enroll, and participate in the NYS Medicaid Program as an CDSMP billing provider.

• CDSMP Programmatic Licensure From SMRC-1st Step

  Prior to applying for enrollment as a CDSMP provider in the NYS Medicaid Program, providers must comply with the standards and guidelines set forth in the Implementation and Fidelity Manual referenced above and obtain programmatic licensure.

• Community Based Organizations (CBOs)

  If you are already recognized by the CDC, but not enrolled in Medicaid
  All CDSMP service providers (e.g., Hospital Outpatient Department (OPD), freestanding Diagnostic and Treatment Center (D&TC), Federally Qualified Health Center (FQHC), provider group practice, or individual/sole practitioner) are required to obtain and enroll an NPI that will be unique to being a CDSMP provider. NPIs enrolled in Medicaid under an existing COS or specialty codes cannot be used to provide or bill for CDSMP services. Providers required to obtain a new NPI as part of this process may do so at any time through the National Plan and Provider Enumeration System (NPPES) webpage located at https://nppes.cms.hhs.gov/#/.

  Providers must have the unique NPI and a valid SMRC programmatic license prior to applying for NYS Medicaid. Newly enrolling CBOs should review, complete, and submit the following NYS Medicaid enrollment forms:

  • CDSMP Recognition Attestation (EMEDNY #434902); and
  • NYS Medicaid Business Enrollment Form (EMEDNY-436701)

  The unique NPI will be used for the purpose of applying for enrollment in the Medicaid program under COS 0572 and will be identified as a CBO. CBOs must also complete the "NYS Medicaid Business Disclosure Form" any time they are requested to revalidate their Medicaid enrollment or anytime a new leader is added to their organization to deliver CDSMP services

  • The NYS Medicaid Business Disclosure Form (EMEDNY-380101)

  Providers should be sure to review all instructions, complete all forms, and submit all required documents. Failure to submit a complete application package may result in delays or a rejected and returned application.

  
  

  CBO Enrollment Forms & Instructions

  
  
• Additional Resources
  • nothing at this time