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Provider Information and Forms

Transfer Request Forms and Defective PA Forms

Nursing Facility Forms
Long Term Care Program Medical Assistance Application
1728 Form – A form that is used to obtain Level of Care  which must be reviewed and signed by the applicant’s primary care physician (PCP). The PCP must be a DC Medicaid provider and must include his/her Medicaid provider # and National Provider Identifier on the 1728 form.
POF: Prescription Order Form

RN Attestation Forms for Annual PCA Level of Need Re-certifications

Person-Centered Individual Service Plan (PCP) Guide

EAPG Documentation
EAPG Grouper Settings
EAPG Inpatient Only List 
EAPG Never Pay List 
Training presentations 
 
APR-DRG Calculator
APR-DRG Calculator Instructions 
 
Specialty Calculator
 
Specialty Calculator Instructions
 
Frequently Asked Questions
 
Info on EAPGs