In a nutshell:

In most cases, no. You can’t bill multiple Medicaid waivers for the same client at the same time, as clients are typically only eligible for one waiver program at a time; billing across waivers can trigger denials or audits unless specifically allowed under your state’s rules.

The (slightly) longer version:

Most Medicaid programs only allow a client to be enrolled in one waiver at a time, and claims must align with that waiver’s services, rates, and billing rules. Attempting to bill two waivers for overlapping services—or even different services on the same day—can result in denials, repayment demands, or compliance violations.

Exceptions and Special Cases

1. Transitional Periods:

Some states allow short-term overlap during a waiver transition (e.g., moving from a developmental disability waiver to an aging waiver), but this must be pre-approved and clearly documented.

2. Split Services (Rare):

In rare cases, clients may receive services from different programs if one covers non-medical care and another covers specialized supports—but this depends entirely on state-specific guidance.

3. Managed Care Coordination:

If the client is enrolled in a managed long-term services and supports (MLTSS) program, the MCO may coordinate services across multiple funding streams; however, billing still flows through a single plan.

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Pro Tip: When in doubt, confirm the client’s active waiver status in your state Medicaid portal or through their care manager before billing. Erring on the side of caution protects your agency from recoupments.

For agencies working with Paradigm, we verify eligibility and authorization before any claim goes out so you never bill the wrong waiver or risk duplicate submissions.

Reminder: This information is not legal advice, not a guarantee, and not a substitute for checking in with your state’s Medicaid authorities and plans directly. Read our full disclaimer here.