Authorizations
How to Become a Medicaid Provider for Home Care
To bill Medicaid for home care you need a state license, a Type 2 NPI, state Medicaid enrollment and screening, waiver or managed care contracts, EVV and authorizations.
Which Medicaid managed care plans do home care agencies contract with in Pennsylvania?
Last verified October 17, 2026 · All Pennsylvania resources
Pennsylvania delivers long-term services and supports through 3 managed care plans in Community HealthChoices (CHC). Pennsylvania's Community HealthChoices is the mandatory managed care program for adults who are dual eligible or who need long-term services and supports because of age or physical disability. Home and community-based services, including personal assistance services, are paid by the CHC managed care organization. All three CHC MCOs operate in every zone, so most agencies contract with all three. People with intellectual disabilities or autism receive waiver services through ODP, which is not part of CHC.
Which plans are there?
- AmeriHealth Caritas (Keystone First in southeast Pennsylvania)
- PA Health & Wellness
- UPMC Community HealthChoices
DHS says each of the five CHC zones is covered by all three CHC MCOs. AmeriHealth Caritas operates as Keystone First CHC in the southeast (https://www.keystonefirstchc.com/).
For the programs that pay for home care, see Pennsylvania Medicaid waivers.
More for Pennsylvania
Medicaid managed care by state: other states
Related guides
Authorizations
How Do You Keep Caregiver Hours Inside a Medicaid Authorization?
Track units remaining, the end date and the service code for every client, and check them before each schedule change. Hours over the cap are unbillable.
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