Virginia Medicaid pays for in-home personal care and related services through 3 programs, including the Commonwealth Coordinated Care Plus (CCC Plus) Waiver and the Family and Individual Supports (FIS) Waiver. DMAS administers CCC Plus; DMAS and DBHDS co-administer the three DD waivers (Building Independence, FIS, CL), and 12VAC30-122 lists DD services collectively, so confirm each DD waiver's services with DBHDS. A DMAS bulletin dated 2026-09-09 ended the live-in caregiver EVV exemption effective 2026-10-01; the F/EA mobile app or IVR are compliant methods, and the web portal is not. Confirm adult state plan personal care coverage with DMAS.
Which Virginia waivers can a home care agency bill?
Each waiver below lists who it covers, the services it pays for, and how providers bill.
Commonwealth Coordinated Care Plus (CCC Plus) Waiver
Population
Medicaid-eligible older adults, people with physical disabilities, and people who are chronically ill or severely impaired who would otherwise need nursing facility admission or a prolonged hospital stay.
Services covered
personal care (agency-directed or consumer-directed)
personal assistance
respite
personal emergency response system
assistive technology
environmental modifications
Billing format
Members in a managed care health plan go through their MCO (fee-for-service members bill DMAS); personal care, respite and companion workers must log shifts with an EVV-compliant method under 12VAC30-60-65.
Children and adults with developmental disabilities living with family, friends or in their own homes; slots are assigned by urgency of need through a waiting list.
Services covered
personal assistance
respite
companion (adults 18+)
in-home support
Billing format
DBHDS processes service authorizations on behalf of DMAS (12VAC30-122-10); EVV applies to personal assistance, respite and companion.
Children and adults with developmental disabilities who need the most intensive supports, including licensed residential options such as group homes and sponsored residential.
Services covered
personal assistance
respite
companion (adults 18+)
in-home support
sponsored residential
group home residential
Billing format
DBHDS processes service authorizations on behalf of DMAS; DBHDS-licensed program sites are exempt from EVV.
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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