New Hampshire Medicaid pays for in-home personal care and related services through 3 programs, including the Choices for Independence (CFI) Waiver and the Developmental Disabilities (DD) Waiver. CFI is a 1915(c) waiver governed by He-E 801; the department authorizes service types, units and frequencies within 6 business days of the case manager's request (He-E 801.06), and respite is limited to 30 24-hour days per state fiscal year (He-E 801.27). Confirm managed care vs fee-for-service delivery, EVV requirements and the full DD and IHS service lists with NH DHHS.
He-E 801.02 lists personal care attendant services as a Medicaid state plan service; confirm program rules with NH DHHS.
Which New Hampshire waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Choices for Independence (CFI) Waiver
Population
Adults 18 and older who meet Medicaid financial requirements and nursing facility clinical criteria (RSA 151-E:3) and need at least one CFI service monthly.
Children and young adults with developmental disabilities from birth through 21 who live at home and have not exited the school system (He-M 503.03(d), He-M 524.03).
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.
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