Long Term Support Services - Home Care Unit
Private Duty Nursing
Private Duty Nursing services provide more individual and continuous care than is available from a home health nursing visit.
Private Duty Nursing Medicaid Services Manual (MSM): Refer to Regulatory section
A doctor’s order is required for Private Duty Nursing services. Your healthcare provider will submit the doctor’s order to a Medicaid enrolled Home Health Agency. The agency will submit the required documentation to HPES to request prior authorization for Private Duty Nursing services.
To request Private Duty Nursing services for a Medicaid recipient
• Complete and fax the Home Health Agency Prior Authorization Request (FA-16) to Hewlett Packard Enterprise Services at (866) 480-9903.
o FA – 16 Form
To enroll as a Medicaid Private Duty Nursing provider
• Complete the enrollment process through HPES
• Enroll as a Provider Type 29 – Home Health Agency