Illinois Medicaid pays for in-home personal care and related services through 3 programs, including the Persons who are Elderly Waiver and the Persons with Disabilities Waiver. Illinois operates 9 HCBS Waivers including programs for Persons with Brain Injury, Persons with Disabilities, Persons with HIV or AIDS, Persons who are Elderly, People who are Medically Fragile/Technology Dependent, the Supportive Living Program, and three Developmental Disabilities programs. HFS is the state Medicaid agency; the Department on Aging operates the Community Care Program.
Which Illinois waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Persons who are Elderly Waiver
Population
Persons who are elderly and would otherwise require care in a nursing facility
Services covered
in-home service (homemaker)
personal care (dressing, bathing, grooming)
adult day service
emergency home response service
meal preparation
shopping and errands
Billing format
EVV via HHAeXchange (state aggregator) or an alternate EVV system; managed by Illinois Department on Aging Community Care Program
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.