District of Columbia Medicaid pays for in-home personal care and related services through 2 programs, including the Elderly and Persons with Physical Disabilities (EPD) Waiver and the Intellectual and Developmental Disabilities (ID/DD) Waiver. The Department of Health Care Finance (DHCF) administers both waivers; the Department of Aging and Community Living (202-724-5626) takes requests for LTSS assessments, and DDS handles ID/DD waiver intake. Confirm EVV system requirements with DHCF.
Yes. People who do not meet EPD waiver criteria may still qualify for Personal Care Aide services through the District's state plan personal care program.
Which District of Columbia waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Elderly and Persons with Physical Disabilities (EPD) Waiver
Population
Older adults and adults with physical disabilities who meet District residency, income, and nursing facility level of care requirements.
Services covered
personal care aide
respite care
case management
personal emergency response system
adult day health
assisted living
environmental accessibility adaptations
participant-directed services
Billing format
DHCF requires EVV as a condition of reimbursement for all personal care services.
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,
caregiver scheduling software for home care agencies.
Simple pricing
From$199/month
Up to 10 caregivers on Starter, 50 on Growth.
More than 50 caregivers? We'll put together a custom Scale plan for your agency.
