Delaware Medicaid pays for in-home personal care and related services through 2 programs, including the Diamond State Health Plan Plus (DSHP Plus) LTSS and the DDDS Lifespan Waiver. The Division of Medicaid and Medical Assistance (DMMA) runs DSHP Plus under the Diamond State Health Plan Section 1115 demonstration; the Division of Developmental Disabilities Services runs the Lifespan Waiver. Confirm with DMMA whether homemaker is a separate covered service and whether personal care is covered outside DSHP Plus.
Which Delaware waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Diamond State Health Plan Plus (DSHP Plus) LTSS
Population
Delaware residents who are elderly or physically disabled and meet the nursing facility level of care; people with AIDS or HIV with qualifying symptoms may also be eligible.
Services covered
personal care
respite care
consumer-directed attendant care
adult day services
personal emergency response
home-delivered meals
case management
assisted living
cognitive services
Billing format
Mandatory managed care through AmeriHealth Caritas, Delaware First Health, or Highmark Health Options; in-home personal care requires EVV through Sandata or an alternate EVV system feeding the state aggregator, and unmatched claims are denied from July 1, 2025.
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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