Kentucky Medicaid pays for in-home personal care and related services through 3 programs, including the Home and Community Based (HCB) Waiver and the Michelle P. Waiver (MPW). The Department for Medicaid Services (Division of Community Alternatives) runs Kentucky's 1915(c) waivers, which also include ABI, ABI LTC, Model II, and CHILD. HCB, MPW, and SCL all have waiting lists, and participant-directed services let members hire their own workers for non-medical, non-residential services. Confirm EVV claim denial dates and state plan personal care coverage with the Department for Medicaid Services.
Which Kentucky waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Home and Community Based (HCB) Waiver
Population
People 65 or older and/or with a physical disability who meet nursing facility level of care (907 KAR 1:022) and Medicaid financial rules.
Services covered
attendant care
non-specialized respite
specialized respite
adult day health care
home delivered meals
environmental and minor home adaptation
Billing format
EVV is required for HCB services; Kentucky uses an open model with the free state-sponsored Therap system or a third-party system.
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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