Division of Developmental Disabilities 

Homepage Individuals & Families Providers Resources


Information & Forms

This webpage provides access to information and forms through the DHHS Developmental Disabilities Division. If you have questions about items posted on this page, please contact the DDD at 402-471-8501.

Provider Contacts with DDD





Guidance for Providers

Contract for Criminal History Backgroud checks with Accurate Background LLC.                                    Effective January 1, 2015 - April 25, 2017



​Specialized Service Provider Guidance to: Authorizations, Billing Guidelines, Service Definitions and Claims Processing.                                                  Effective July 1, 2015



Nebraska DD Adult Day Waiver.                                  Effective January 1, 2011



Nebraska DD Adult Comprehensive Waiver.                Effective January 1, 2011



MC-40 Developmental Index for DD Waiver Eligibility 09-2011



Notification of Death Form

  Provider Report to Notify of Death of Individual
​​Technical Assistance Form
 Contact Technical Assistance MS Word Format
Individual Budget Amount (IBA)
​ IBA Exception Flow Chart PDF
​ IBA Exception Request Form Instructions IBA Exception Request Instructions - July 2015
​ IBA Exception Request Form IBA Exception Request - July 2015

Medicaid Waiver Medical Assessment Form

​ For Physician to Submit with Claim PDF

 Contact Us
Nebraska Department of Health & Human Services
Division of Developmental Disabilities
P.O. Box 95026
Lincoln, NE 68509
(402) 471-8501

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