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Personal Care services are a benefit for Colorado Medicaid clients who meet the following criteria:
The PCAT is used to consistently evaluate an individual’s need for Personal Care services. It was created over two years in collaboration with internal and external stakeholders.
All Personal Care services must be pre-approved in a Prior Authorization Request (PAR) process. The personal care provider will need to submit at least these two required documents:
1. Personal Care Assessment Tool (PCAT). The PCAT needs to be completed by the personal care provider.
2. 485 Home Health Certification and Plan of Care Form (or another form with the same content) (Plan of Care). The Plan of Care Form needs to be completed by the client’s doctor.
The Plan of Care Form must order in-home personal care services and describe in detail what services are medically necessary and how often they are needed. The personal care provider will submit the completed forms in an online Prior Authorization Request (PAR).
For more information about this process, see the Pediatric Personal Care Special Provider Bulletin.
Provider List - Pediatric Personal Care Providers listed by county
Part of the Department’s goal is to increase the number of personal care providers across the state who accept Medicaid to help Medicaid members receive personal care services. If you are part of a Class A or class B agency interested in providing personal care services, contact us at 303-866-3447 or PersonalCare@state.co.us.
Frequently Asked Questions for Providers
Special Provider Bulletin
Personal Care Billing Manual
Personal Care Rule at 10 CCR 2505-10 8.535
PCAT Training Webinar
Case Manager Training