North Dakota Medicaid pays for in-home personal care and related services through 2 programs, including the Home and Community-Based Services (HCBS) Waiver - Aged & Disabled and the Traditional Individual with Intellectual Disabilities and Developmental Disabilities (IID/DD) Waiver. HHS Adult and Aging Services runs the HCBS waiver and MSP-PC; state-funded SPED and Ex-SPED programs fill gaps. The HCBS waiver renewal took effect 2026-01-01 and the IID/DD waiver renewal 2026-06-01. Service lists are taken from the October 2025 EVV billing manual's code tables, not a waiver service definition page; prior authorization wording was not directly confirmed.
Yes. Medicaid State Plan Personal Care Services (MSP-PC) help adults 18 and older on traditional Medicaid or with medically frail status with bathing, dressing, transferring, toileting, meals, housework and laundry; services are set with an HCBS case manager.
Which North Dakota 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 Services (HCBS) Waiver - Aged & Disabled
Population
Adults 18 and older on traditional Medicaid who meet nursing home level of care and need services longer than 90 days.
Services covered
personal care
extended personal care
homemaker
chore
companionship
respite care
supervision
non-medical transportation
adult family foster care
transitional living
Billing format
Claims are matched to EVV data; Therap is the state's default EVV system and Sandata is the data aggregator (open model).
Traditional Individual with Intellectual Disabilities and Developmental Disabilities (IID/DD) Waiver
Population
People with intellectual and developmental disabilities.
Services covered
homemaker
in-home supports
respite
independent habilitation
Billing format
Licensed DD providers and self-directed in-home support and respite providers must use EVV; self-directed EVV is supported by Veridian Fiscal Solutions.
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
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