Massachusetts Medicaid pays for in-home personal care and related services through 2 programs, including the Frail Elder Waiver (FEW) and the MassHealth Personal Care Attendant (PCA) Program. Frail Elder Waiver services are coordinated through the network of 24 Aging Services Access Points (ASAP). Providers contracting with ASAPs for Homemaker/Personal Care must complete the Notice of Intent (NOI) procurement process. The PCA program is consumer-directed — consumer-employers approve PCA timesheets through the EVV portal.
Which Massachusetts waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Frail Elder Waiver (FEW)
Population
Frail elders aged 60 and older who meet the level of care for a nursing facility but prefer to remain in the community
Services covered
personal care
homemaker
adult day health
respite
home-delivered meals
transportation
case management
Billing format
Fee-for-service through Aging Services Access Points (ASAPs); EVV via Sandata or Alt-EVV
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
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