Nevada Medicaid pays for in-home personal care and related services through 2 programs, including the Home and Community Based Waiver (HCBW) for the Frail Elderly and the HCBS Waiver for Persons with Physical Disabilities (PD). ADSD operates the FE and PD waivers with Nevada Medicaid (DHCFP); DWSS determines financial eligibility, and Nevada also has a waiver for individuals with intellectual disabilities. PD waiver details come from a 2021 ADSD presentation (income limit then $2,313 per month); confirm current limits and whether waiver services are fee-for-service or managed care with ADSD.
Yes. Nevada Medicaid covers state plan Personal Care Services (provider types 30 and 83), which require EVV through Sandata.
Which Nevada 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 Waiver (HCBW) for the Frail Elderly
Population
Medicaid recipients 65 years of age and older who, without waiver services, would require institutional care in a hospital or nursing facility.
Services covered
homemaker
respite
chore
adult companion
social adult day care
personal emergency response system
case management
Billing format
Provider Type 48 claims to Nevada Medicaid (Gainwell fiscal agent) on 837P, one authorization per claim, one calendar month per claim; homemaker, chore, respite and companion are subject to EVV through Sandata.
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.
