Medicaid Home Health Services

Home Health services may include:

  • Home Health visits (skilled nursing and home health aide) for Medicaid recipients ages birth through end of life; and
  • Private duty nursing and personal care services for Medicaid recipients under 21 years old.

Home Health (HH) Visits is for recipients of all ages

Home Health visits are limited to a maximum of three intermittent visits per day for non-pregnant adults. The visits may be any combination of licensed nurse and home health aide visits.

Private Duty Nursing (PDN) is skilled nursing services for recipients under 21 years old

Private Duty Nursing (PDN) services are medically-necessary skilled nursing services that maybe provided to recipients under the age of 21 years old in their home or other authorized settings to support the care required by their complex medical condition.

Personal Care Services (PCS) are for recipients under 21 years old

Personal Care Services (PCS) provide medically-necessary assistance with activities of daily living (ADL) and age appropriate instrumental activities of daily living (IADL) that enable the recipient to accomplish tasks that they would normally be able to do for themselves if they did not have a medical conditional or disability.

Reimbursable Personal care services

  • ADL
    • Eating (oral feeding and fluid intake);
    • Bathing;
    • Dressing;
    • Toileting;
    • Transferring; and
    • Maintaining Continence.
  • IADL
    • Personal Hygiene;
    • Light Housework;
    • Meal Preparation;
    • Grocery shopping; and
    • Money Management.

Note: Please see the Home Health Services Coverage and Limitations Handbook for an exhaustive list of covered services.

Medicaid reimburses Home Health services that

  • Do not duplicate another provider’s service,
  • Are medically necessary for the treatment of a specific documented medical disorder, disease or impairment, and
  • Are provided under the care of an attending physician.

*Note: Chapter 59G-1.010 (166), Florida Administrative Code defines medically necessary.

Please consult the Home Health Services Coverage and Limitations Handbook for more information on Home Health Services.