Updated: January 2026
Purpose
ND Medicaid covers independently licensed practitioners referred to in policy as Other Licensed Practitioners (OLPs) pursuant to 42 CFR § 440.60. Enrolled OLPs recognized by ND Medicaid and authorized under Attachment 3.1-A Item 6.d and Attachment 3.1-B Item 6.d of the state plan may bill ND Medicaid for covered services allowed within their scope of practice.
Applicability
Eligible Providers
To receive payment from ND Medicaid, the eligible servicing and billing providers must be enrolled with ND Medicaid on the date of service, and their National Provider Identifiers (NPIs) must be active in their Medicaid enrollment records. Servicing providers acting as a locum tenens provider must be enrolled with ND Medicaid, and services they provide must be billed with their NPI. Please refer to provider enrollment for additional details on enrollment eligibility and supporting documentation requirements.
Practitioners currently recognized as OLPs are:
- Nurse Practitioners (NPs)
- Physicians Assistants (PAs)
- Certified Nurse Midwives (CNMs)
- Clinical Nurse Specialists (CNSs)
- Licensed Registered Pharmacists (RPh)
- Licensed Psychologists
- Licensed Clinical Social Workers (LCSWs)
- Licensed Master Social Workers (LMSWs)
- Licensed Professional Clinical Counselors (LPCCs)
- Licensed Professional Counselors (LPCs)
- Licensed Marriage and Family Therapists (LMFTs)
- Licensed Addiction Counselors (LACs)
- Licensed School Psychologists who have earned a specialist degree in school psychology from a nationally recognized school psychology accreditation body or who have obtained the national school psychologist certification.
Requirements
NPs, CNMs, CNSs, and PAs must receive an individual provider number even if they are a member of a group, clinic, or employed by an outpatient hospital or other organized health care delivery system. Medicaid-billable services within an NP, CNM, CNS, or PA scope of practice consist of services otherwise covered as physician services.
Documentation Requirements
General Requirements
Providers must keep legible medical and financial records that fully justify and disclose the extent of services provided and billed to ND Medicaid. Records must be retained for at least 7 years after the last date the claim was paid or denied. Providers must follow the documentation requirements in the Provider Requirements Policy.
Definitions
Other Licensed Practitioner – any person licensed or certified under state law to provide medical or behavioral health services and practicing within the scope of his or her licensure pursuant to the applicable state law for his or her licensure or certification.
References
Related Policies
Contact
Medical Services
600 East Boulevard Ave
Bismarck, ND 58505-0250
Phone: (701) 328-2310
Email: dhsmedicalservices@nd.gov
Policy Updates
October 2025
- Definitions
- Added definition of OLP
- Related Policies
- Added links to ORP and Professional Medical and Surgical Services
January 2026
- Eligible Providers
- Added LMSWs
April 2026
- Formatting changes made throughout.
October 2026
- Licensed Registered Pharmacists added to the list of OLPs. This addition was effective in January 2026 due to Senate Bill No. 2402 of the Sixty-ninth Legislative Assembly of North Dakota.