Tennessee Medicaid pays for in-home personal care and related services through 2 programs, including the TennCare CHOICES in Long-Term Services and Supports and the Employment and Community First (ECF) CHOICES. TennCare runs CHOICES and ECF CHOICES as managed LTSS through its health plans. Personal care visits are limited to 2,580 hours per calendar year, in-home respite to 216 hours and inpatient respite to 9 days. Confirm DIDD-operated 1915(c) waivers, Katie Beckett, EVV requirements and any state plan personal care benefit with TennCare.
Which Tennessee waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
TennCare CHOICES in Long-Term Services and Supports
Population
Seniors 65+ and adults 21+ with physical disabilities who qualify for nursing home care (Group 2) or are at risk of it (Group 3) and meet SSI or Medicaid LTSS financial rules (income up to $2,982 per month in 2026).
Services covered
personal care visits
in-home respite care
inpatient respite care
adult day care
companion care (Group 2 consumer direction only)
community living supports
assisted care living facility
employment services
Billing format
Delivered through TennCare health plans (BlueCare, UnitedHealthcare Community Plan, Wellpoint); providers contract with and bill the member's plan.
People with an intellectual disability (onset before 18) or developmental disability (onset before 22) who qualify financially for TennCare; Groups 4-8 by age and need, with a referral list when funding is limited.
Services covered
personal assistance
respite
supportive home care
community integration support services
family caregiving supports
employment services
Billing format
Members get help through their TennCare health plan (Wellpoint, BlueCare or UnitedHealthcare Community Plan); billing path not stated.
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.
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