KodaComplyHome care rules, state by state, in plain EnglishDocuments collected September 22, 2026

Utah home care rules

Utah licenses personal care agencies and home health agencies through the Office of Licensing in the Department of Health and Human Services (DHHS). Medicaid contracts with four health plans (ACOs), while home and community-based waiver services are paid by Medicaid directly. Several Aging Waiver rates went up on July 1, 2026, and Medicaid has started re-checking the enrollment of high-risk billing providers.

69 official documents·collected September 22, 2026·checked against them September 23, 2026
License for non-medical home care?YesPersonal Care Agency license (R432-725) from the DHHS Office of Licensing · one-year term, with a two-year option for providers in good standing
License for home health?YesHome Health Agency license (R432-700). Medicaid also expects home health agencies to be certified through CMS.
EVVRequiredPersonal care and home health visits, State Plan and waiver. You pick the vendor; send records within three months of the claim.
Medicaid health plans4 ACOsHealth Choice Utah, Healthy U, Molina Healthcare, Select Health Community Care. Waiver services are carved out and paid by Medicaid directly.

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Act nowJuly 2026 bulletin · letters from July 15, 2026

If Medicaid sends you a revalidation letter, you have 90 days

Utah Medicaid is running a two-year mid-cycle revalidation. It covers billing providers in the high risk level that have not revalidated since July 1, 2025. Medicaid mails a letter to your 'Pay-To' address in PRISM, and you must finish revalidation in PRISM within 90 days. If you don't, your Medicaid enrollment ends.

What to do: Check that your PRISM addresses, email and phone are right, and make sure your billing staff watch the mail for the letter.
Read this monthRate sheet effective July 1, 2026

Several Aging Waiver rates went up on July 1, 2026

The Aging Waiver rate for agency personal attendant services (T1019) went from $7.17 to $9.30 per 15 minutes. Homemaker (S5130) went from $8.42 to $9.00, companion (S5135) from $6.62 to $8.25 and unskilled respite (S5150) from $6.01 to $8.25.

What to do: Check that your billing uses the new rates for services from July 1, 2026.
Read this monthFrom January 1, 2026 · Personal Care manual updated July 2026

Personal care is billed in 15-minute units

T1019 personal care is now reported in 15-minute units instead of one unit per hour. The rural add-on (modifier TN) is capped at 1.75 times the rate. In July 2026 Medicaid also clarified the manual's wording on where the rural add-on applies.

What to do: Spot-check a few recent T1019 claims for the right units, and read Chapter 12 of the July 2026 Personal Care Services manual.
Read this monthChecklist revised May 20, 2026

Inspectors now check the 2026 law changes

OL's Personal Care Agency inspection checklist now includes the 2026 law changes, enforceable from May 20, 2026. H.B. 472 requires critical incident reporting across human services, health facility and child care programs. The checklist also covers parents' access to children's medical records (H.B. 259) and the life-sustaining treatment order rule R432-31, updated May 7, 2026. Under that rule, if a client has an order, a personal care agency must make sure a copy is left in the home.

What to do: Read the checklist's 'Legislative Updates 2026' pages and update your incident reporting and life-sustaining treatment order policies.

Deadlines coming up

Dates taken from the rules and notices as we read them.

464days
December 31, 2027

Parents' access to children's electronic medical records: daily fines start after this date

Listed in the Personal Care Agency inspection checklist (H.B. 259). After that date, a health care facility that restricts a parent's access (other than for the reasons the law allows) faces a $1,000 civil fine for each day.