Medicaid self-directed care
Personal Care Attendant (PCA) Program
Checked
- Who qualifies
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MassHealth members who can be cared for at home, whose disability is permanent or chronic and keeps them from doing activities of daily living without physical help, who need physical help with two or more activities of daily living as determined by a personal care management (PCM) agency, and whose PCA services MassHealth finds medically necessary and authorizes.
The member, or a surrogate if needed, hires, trains, schedules, supervises and directs the PCA.
Source: 130 CMR 422.000: Personal Care Attendant Services, MassHealth Provider Manual (Transmittal PCA-27, 07/03/26)Checked
- Can a family member be paid
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Yes. Yes, except a spouse, a parent of a minor, or a legal guardian. Another family member, a friend or another individual can serve as a PCA.
A parent of a minor, a spouse or a legal guardian can be the member's home health aide or complex care assistant instead, but not the member's PCA.
Source: Comparison of Services: Home Health Aide, Personal Care Attendant, Complex Care Assistant and Continuous Skilled Nursing (MassHealth)Checked
- Can a spouse be paid
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No. No. Federal law does not allow a spouse to be a PCA.
A spouse can be the member's home health aide or complex care assistant, but not the member's PCA.
Source: Comparison of Services: Home Health Aide, Personal Care Attendant, Complex Care Assistant and Continuous Skilled Nursing (MassHealth)Checked
- Can a legal guardian be paid
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No. No. Federal law does not allow a legal guardian to be a PCA.
Source: Comparison of Services: Home Health Aide, Personal Care Attendant, Complex Care Assistant and Continuous Skilled Nursing (MassHealth)Checked
- Hours limit
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A member can schedule one PCA for no more than 50 hours a week, counting the hours that PCA works for other members. With MassHealth authorization, a PCA can work up to 60 hours a week for a temporary, long-term or emergency need.
Source: 130 CMR 422.000: Personal Care Attendant Services, MassHealth Provider Manual (Transmittal PCA-27, 07/03/26)Checked