MedicaidAdministrativeLow impact
Two All-Provider Handbook forms revised
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Sep 1, 2002
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid has revised two provider forms effective immediately: the Provider Change of Address or Status form (HCF 1181) and the Declaration of Supervision for Nonbilling Providers form (HCF 1182). The forms have been simplified and certain mental health providers are no longer required to submit supervision declarations.
Action Required
Immediately: Replace old versions of Provider Change of Address or Status form (HCF 1181) and Declaration of Supervision for Nonbilling Providers form (HCF 1182) with the new revised forms. Download updated forms from Wisconsin Medicaid website or photocopy from this update. Note that AODA counselors, Master's-level psychotherapists, and psychiatric nurses no longer need to submit supervision declarations.