General Waiver Information

     New Choices Waiver Information

     New Choices State Implementation Plan

Client Information

Provider Information

     Assisted Living Room and Board Worksheet

     Care Plan Form

     Place of Service Codes

     NCW Information and Referral Instructions 

     Fiscal Year 2009 Rate Table

     CMS 1500 Example Claim Form

     CMS 1500 Example Claim Form Instructions

     Utah Medicaid Provider Enrollment Information

     NPI Application

     IRS W-9 Form 

     Service Specifications

     Provider Checklist

     General Service Provider Letter 12/13/06

     Assisted Living Provider Letter 12/05/06

     Attachment A

     Attachment B - Residential Services

     Attachment B - Case Management

Contact Information

     Kathleen Bowman
     (801) 538-6497

     Vicki Ruesch

     (801) 538-6148