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

Billing information

Last Edited: 2/2/2016