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Texas Medicaid waivers that pay for home care

Last verified April 30, 2026 · All Texas resources

Texas Medicaid pays for in-home personal care and related services through 3 programs, including the STAR+PLUS Home and Community Based Services (HCBS) and the Community Living Assistance and Support Services (CLASS) Waiver. Texas HCBS waivers operate under different authorities — STAR+PLUS HCBS is a 1915(b)/(c) managed care waiver; CLASS is a non-capitated 1915(c) waiver; MDCP serves children. HCS, CLASS, and MDCP individuals are excluded from STAR+PLUS. The HCBS Settings Rule applies to all three programs.

Which Texas waivers can a home care agency bill?

Each waiver below lists who it covers, the services it pays for, and how providers bill.

STAR+PLUS Home and Community Based Services (HCBS)

Population
Adults with disabilities and elderly individuals who need a nursing facility level of care but want to live in the community
Services covered
  • personal assistance services
  • respite
  • adult foster care
  • adult day care
  • home-delivered meals
  • minor home modifications
  • nursing services
Billing format
Capitated managed care via STAR+PLUS MCOs; EVV via HHAeXchange (state-funded EVV system) or PSO; aggregator TMHP
Prior authorization
Required
Open waiver page (opens in a new tab)

Community Living Assistance and Support Services (CLASS) Waiver

Population
Persons with intellectual or developmental disabilities (non-IDD related related conditions originating before age 22)
Services covered
  • habilitation
  • respite
  • nursing
  • adaptive aids
  • minor home modifications
  • case management
Billing format
Non-capitated 1915(c); EVV via HHAeXchange or PSO; aggregator TMHP
Prior authorization
Required
Open waiver page (opens in a new tab)

Medically Dependent Children Program (MDCP)

Population
Children and young adults under 21 who require nursing facility level of care
Services covered
  • respite
  • adjunct support services
  • minor home modifications
  • adaptive aids
  • transition assistance services
Billing format
Capitated managed care via STAR Kids MCOs; EVV via HHAeXchange or PSO; aggregator TMHP
Prior authorization
Required
Open waiver page (opens in a new tab)

Sources

More for Texas

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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