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

Washington home care rules

Washington's Department of Health licenses home care, home health and hospice agencies under one in-home services agency license. Medicaid in-home personal care is authorized by the Department of Social and Health Services (DSHS) and billed to ProviderOne, while five Apple Health (Medicaid) health plans pay for home health for their members. In 2026, ProviderOne began denying personal care and respite claims with missing EVV data, and WA Cares benefits started on July 1, 2026.

71 official documents·collected September 22, 2026·checked against them September 22, 2026
License for non-medical home care?YesIn-home services agency license, home care category, from the Department of Health (DOH) · first license 12 months, then 2 years. Exempt, among others: family members, people hired directly by the client, individuals under contract with DSHS, and the consumer directed employer.
License for home health?YesSame DOH in-home services license, home health category. To contract with the Health Care Authority (HCA) for Apple Health home health, an agency must also be Medicare-certified and sign a Core Provider Agreement.
EVVClaims now denyPersonal care and respite: ProviderOne denies claims missing EVV data (caregiver ID from Jan. 1, times from April 1, GPS location from July 1, 2026). Home health since Jan. 1, 2024. Agency-chosen system.
Medicaid health plansNot for personal care5 Apple Health plans (Coordinated Care, Community Health Plan of Washington, Molina, UnitedHealthcare, Wellpoint) pay for home health. In-home personal care is authorized by DSHS and billed to ProviderOne. A plan may fund extra behavioral health personal care hours (Behavioral Health Wraparound Support), but DSHS still authorizes them.

What changed, and what to do about it

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

Act nowEdits set to deny Jan. 1, April 1 and July 1, 2026 · guide updated July 2026

ProviderOne now denies personal care and respite claims with missing EVV data

DSHS moved its EVV edits from 'pay and report' to 'deny' in three steps: missing or invalid caregiver SSSOP IDs from January 1, missing or wrong start and end times (and units longer than the shift) from April 1, and missing GPS location from July 1. This includes claims submitted after January 1, 2026 for earlier dates of service.

What to do: Check recent remittance advice for remark codes N290, N890 and N820. Roster every new caregiver before their first Medicaid shift, and split overnight shifts by date.
Read this monthWSR 26-04-110, effective June 1, 2026

DOH license fee rule updated June 1, 2026

DOH updated WAC 246-335-990. A new license costs $5,000 for each service category. Two-year home care renewals run $2,400 to $3,700 by FTE count, or $1,700 to $2,600 for agencies under contract with and monitored by DSHS or an AAA that meet DOH's substantial-equivalency requirements. The late fee is $50 a day, up to $1,000.

What to do: Check your FTE count and contract status before your next renewal, and budget from the current fee table.
Read this monthEmergency rule Aug. 25, 2025 · rule update WSR 26-12-065 effective July 3, 2026

Home care aides now have 365 days to certify

Under a 2025 law, DOH extended the home care aide certification deadline from 200 to 365 days from hire, or 425 days (instead of 260) with a provisional certificate, which is for workers with limited English. It applies to applications submitted by December 31, 2027. The 120-day training deadline and the 14-day application deadline did not change.

What to do: Update your hiring tracker to 365 days, but keep chasing the 120-day training and 14-day application dates.
Read this monthRCW 74.39A.310 as amended in 2026

Vendor-rate money must go to direct care workers, with proof from July 2027

Increases in the state home care agency vendor rate may be used only for the wages, benefits and related employer costs of workers who give direct care. Starting July 1, 2027, DSHS or its designee will verify spending, and each agency must submit an independent third-party audit or a written attestation from the workers' union.

What to do: Start tracking how each rate increase is spent on direct care wages and benefits, and decide which kind of proof you will use.
For the recordRCW 50B.04 · DOH roadmap, July 2026

WA Cares benefits began July 1, 2026

Eligible people can now use WA Cares benefits, up to $36,500 over a lifetime (adjusted for inflation), for services that include in-home personal care. Benefits are paid to long-term services and supports providers registered with DSHS, and licensed in-home services agencies are one kind of provider. Qualified family members may be paid through a licensed home care agency.

What to do: If you want WA Cares clients, ask DSHS how to register as a provider. We do not yet hold the WA Cares provider toolkit.

Deadlines coming up

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

281days
July 1, 2027

DSHS starts verifying vendor-rate spending

From this date, DSHS or its designee verifies that vendor-rate money went to direct care wages and benefits. Each home care agency must submit an independent audit or a union attestation; the law gives no filing deadline (RCW 74.39A.310).

464days
December 31, 2027

Last day of the 365-day home care aide timeline

The 365-day (425 with a provisional certificate) certification timeline applies to applications submitted by this date (WAC 246-980-030 and -040).