Idaho Medicaid pays for in-home personal care and related services through 2 programs, including the Aged and Disabled (A&D) Waiver and the Adult Developmental Disabilities (DD) Waiver - Traditional Services. The Idaho Department of Health and Welfare administers both waivers, mostly fee-for-service; dual-eligible members get long-term care through Molina or UnitedHealthcare plans. Confirm EVV requirements with the Department of Health and Welfare.
Yes. Idaho's State Plan Personal Care Services (PCS) covers help with personal hygiene, bathing, toileting, dressing, food and nutrition, and minor housekeeping.
Which Idaho waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Aged and Disabled (A&D) Waiver
Population
Older adults and adults with disabilities on Medicaid who demonstrate a need for the level of care required for institutional services.
Services covered
attendant care
companion
homemaker
chore
respite care
adult day health
home-delivered meals
personal emergency response system
non-medical transportation
adult residential care
Billing format
Overseen by the Bureau of Long Term Care; for dual-eligible members, UAI assessment, service plan, and authorizations go through Molina Healthcare of Idaho or UnitedHealthcare Community Plan.
Adult Developmental Disabilities (DD) Waiver - Traditional Services
Population
Adults with developmental disabilities who qualify for Idaho's DD waiver and choose traditional (non-self-directed) services.
Services covered
respite
chore
residential habilitation (supported living, certified family home)
adult day health
supported employment
home delivered meals
personal emergency response system
non-medical transportation
service coordination
Billing format
Services follow an Individual Support Plan written with a plan developer and submitted to the Bureau of Developmental Disability Services; a self-directed option (My Voice, My Choice) is also available.
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.
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