Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Do I need a license to run a non-medical home care agency in Idaho?
No state license.
The documents we hold show no Idaho license for non-medical home care. Idaho's facility licensing law covers hospitals, nursing facilities and intermediate care facilities. To serve Medicaid clients you enroll as a Personal Assistance Agency: BLTC reviews your policies, RN license and training plan, and you attend mandatory training. The A&D Waiver's provider qualifications for PAAs list background checks and the training matrix, not a license.
Sources (3)
Written and checked September 23, 2026
Do home health agencies need a state license in Idaho?
No, not since 2025.
Idaho Code 39-1303(8), added in 2025, says neither Medicare-certified hospice agencies nor home health agencies are required to be licensed or certified under the chapter. To bill Medicaid, a home health agency must be certified to take part in Medicare, have an NPI, sign a provider agreement, and post a surety bond of at least $50,000.
Sources (2)
Written and checked September 23, 2026
Which services need EVV in Idaho?
PCS, Attendant Care, Homemaker, Respite and home health.
IDAPA 16.03.26.054 requires EVV for home health, State Plan Personal Care Services, and Attendant Care, Homemaker and Respite under the A&D Waiver. Personal Assistance Agencies use codes T1019, S5125, S5130 and T1005. Home health agencies must use EVV for all services except medical supplies and equipment.
Sources (3)
Written and checked September 23, 2026
What EVV system do I have to use?
Any system certified with Sandata.
Agencies can choose any EVV vendor that is certified and compatible with the state's aggregator, Sandata. You must finish testing and get production credentials before you bill. You also need a written EVV policy and documented participant consent.
Sources (3)
Written and checked September 23, 2026
How many manually edited EVV visits are allowed?
Fewer than 15%.
BLTC reviews PAA EVV data every quarter and requires 85% of visits to be verified automatically. The billing handbook says any agency with 15% or more manually verified visits in a quarter must improve. Those agencies are contacted and may be asked for an EVV Action Plan. An agency that does not respond has its claims payments held, and repeated problems can lead to limited enrollment and a Program Integrity referral.
Sources (2)
Written and checked September 23, 2026
Can a new caregiver start before finishing training?
No.
All Direct Care Professionals must fully complete the Provider Training Matrix before giving direct care, and there is no grace period. Training from another agency does not transfer unless it was the approved online courses with certificates of completion. Special endorsement training must be done by the agency RN.
Sources (3)
Written and checked September 23, 2026
Can a caregiver start work before the background check clears?
Yes, provisionally, in some cases.
Under IDAPA 16.05.06, a worker can provide services from the day the application is submitted and reviewed by the agency, if no disqualifying crimes are disclosed and fingerprints are sent in the required time. Fingerprints must reach DHW within 21 days of the application. The agency decides whether the person poses a risk before letting them work.
Sources (2)
Written and checked September 23, 2026
Can a spouse or parent be paid to care for a family member?
No, not after July 15, 2025.
The Family Personal Care Services flexibility ended. After July 15, 2025, parents of minor children and spouses may not be the paid caregiver for Personal Care Services or A&D Waiver services. The current Medicaid rule also says A&D Waiver direct care workers cannot be the participant's spouse. They may still work for an agency caring for other people. BLTC refers suspected cases to the Medicaid Program Integrity Unit and suggests a screening question at intake.
Sources (3)
Written and checked September 23, 2026
Who authorizes and pays for clients on both Medicare and Medicaid?
If they are in a duals plan, that plan: Molina or UnitedHealthcare.
For dual-eligible people enrolled in Idaho Medicaid Plus (IMPlus) or the Medicare Medicaid Coordinated Plan (MMCP), Molina Healthcare of Idaho or UnitedHealthcare Community Plan of Idaho issues all authorizations. BLTC does not. The plans serve listed counties, so check the client's enrollment. Work with the plan directly on claims and share of cost. You still collect EVV for these visits.
Sources (3)
Written and checked September 23, 2026
What does Idaho Medicaid pay for personal care?
$6.11 per 15 minutes.
The PAA fee schedule (effective Sept. 1, 2025) pays $6.11 per 15 minutes for Personal Care Services (T1019) and Attendant Care (S5125). Homemaker is $5.26, and Companion and Respite are $5.54. The PCS and Attendant Care rates were exempt from the 4% cut of Sept. 1, 2025.
Sources (2)
Written and checked September 23, 2026