Colorado Medicaid pays for in-home personal care and related services through 3 programs, including the Elderly, Blind, and Disabled Waiver (EBD) and the Supported Living Services Waiver (SLS). The Department of Health Care Policy and Financing (HCPF) runs Health First Colorado; local Case Management Agencies handle enrollment and person-centered support plans. Personal care and homemaker for waiver members are delivered under CFC, with waiver members moving over from July 2025 through 2026.
Yes. Community First Choice (1915(k)) became active July 1, 2025 and covers personal care, homemaker, health maintenance activities, home delivered meals, PERS, and remote supports, through agencies or self-directed IHSS/CDASS; HCPF says CFC personal care providers need a Class A or Class B license.
Which Colorado waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Elderly, Blind, and Disabled Waiver (EBD)
Population
People 65 and older with a significant functional impairment, or adults 18-64 who are blind, physically disabled, or have HIV/AIDS, who need nursing facility level of care.
Services covered
respite
adult day services
alternative care facilities
life skills training
non-medical transportation
peer mentorship
home accessibility modifications
Billing format
EVV has been mandatory in Colorado since August 3, 2020 for services that require it; HCPF compliance reports are provided within Sandata.
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.
Private pay means higher rates and fast payment; Medicaid means steady volume at state-set rates with authorizations and EVV. Compare rates, cash timing and admin before you mix them.
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.
Four units equal one hour. How to convert units to hours, the common HCPCS codes, how states round partial units, and how to stay inside the authorization.
These free tools are made by the team behind Caregiver Scheduling,
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