Service Agencies
Service Agency/Provider Application
The 2023-2024 Service Agency Application will open on May 1st. Emails letting providers know the application has opened will be sent to all approved providers from the 2022-2023 application cycle.
If your contact information has changed since last year, please log into the application to update your profile.
New providers who have not used the new website must create a user profile before completing an application.
Misc. Information
Provider Rates & Agreements Etc.
Provisionally Approved Service Agency Rates
Search Below for Approved Service Agency Rates
2022/2023 Approved Service Agency Rates
2007-2022 Approved Service Agency Rates
Verification Search
Licensure/Certification/Facility
Licensure Status of Nebraska Health Professions/Occupations Lookup
Service Agency Claim for Non-Ward Educational Service Reimbursement
79-215
Service Agency Claim Form (fillable pdf)
(if you are having difficulty viewing this document, please download and view it directly in Adobe Reader)