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Missouri Medicaid waivers that pay for home care

Last verified October 17, 2026 · All Missouri resources

Missouri Medicaid pays for in-home personal care and related services through 4 programs, including the Aged and Disabled Waiver (ADW) and the Independent Living Waiver (ILW). DHSS Division of Senior and Disability Services administers the ADW, ILW and state plan personal care; DMH runs the DD waivers. ADW applicants may need fee-for-service coverage, so confirm with MO HealthNet. Missouri uses an open EVV model; claims for personal care, homemaker, chore and in-home respite (including MCO-reimbursed) are matched to EVV data.

Yes. MO HealthNet State Plan Personal Care is delivered through an agency model (13 CSR 70-91.010 and 19 CSR 15-7) or a consumer-directed services model (19 CSR 15-8), and personal care claims are matched to EVV data.

Which Missouri 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 Waiver (ADW)

Population
People age 65 and over, and ages 63-64 with physical disabilities, who would otherwise need nursing home care.
Services covered
  • homemaker
  • chore
  • basic respite
  • advanced respite
  • adult day care
  • home-delivered meals
Billing format
Fee-for-service MO HealthNet claims; homemaker, chore and DSDS-authorized in-home respite require EVV data that integrates with the state EVV Aggregator Solution hosted by Sandata.
Prior authorization
Required
Open waiver page (opens in a new tab)

Independent Living Waiver (ILW)

Population
Adults 18-64 with a physical or cognitive disability who would otherwise need nursing facility care and meet Consumer-Directed State Plan Personal Care eligibility.
Services covered
  • consumer-directed personal care beyond state plan limits
  • financial management services
  • case management
  • environmental accessibility adaptations
  • specialized medical equipment and supplies
Billing format
Fee-for-service MO HealthNet claims; consumer-directed personal care requires EVV through the state Sandata aggregator.
Prior authorization
Required
Open waiver page (opens in a new tab)

Structured Family Caregiver Waiver (SFCW)

Population
Adults 21 and over with Alzheimer's disease or a related dementia who would otherwise need nursing facility care.
Services covered
  • personal care and homemaker services from a live-in primary caregiver
  • medication oversight
  • appointment escorting
Billing format
Not specified
Prior authorization
Required
Open waiver page (opens in a new tab)

Community Support Waiver (CSW)

Population
People of all ages with developmental disabilities who live in a community arrangement, usually with family.
Services covered
  • personal assistant
  • in-home respite
  • out-of-home respite
  • day habilitation
  • home-delivered meals
  • employment services
  • transportation
Billing format
Not specified
Prior authorization
Required
Open waiver page (opens in a new tab)

Sources

More for Missouri

Medicaid waiver lookup: other states

Related guides

Authorizations

How to Become a Medicaid Provider for Home Care

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.

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