Nebraska Medicaid Billing For Home Care Providers
Nebraska runs HCBS across multiple programs and uses two EVV systems depending on the program: Netsmart (Mobile Caregiver+) for PAS/AD/TBI and Therap for DD waivers. Paradigm streamlines EVV reconciliation, claims, and collections so you get paid on time.
Electronic Visit Verification
Nebraska requires EVV for PAS and many HCBS services (Cures Act). In 2025, DHHS implemented additional edits: visits must start/end with an approved verification method (GPS or approved landline IVR), signatures are enforced for GPS visits, and several “critical errors” render visits unbillable unless successfully appealed. DD waiver providers use the Therap EVV module; PAS/AD/TBI providers use Netsmart Mobile Caregiver+.
EVV Requirements
- Verification methods: GPS or approved landline IVR; unregistered IVR numbers trigger VIVR errors.
- Critical errors (unbillable without state adjustment): NOSL (no scheduled location), VVER (missing verification), VIVR (IVR number mismatch), VLOC (location outside geofence).
- DD programs: Use Therap for EVV and billing; PAS/AD/TBI use Netsmart.
EVV Aggregator
- Netsmart (Mobile Caregiver+) is the state EVV/claims platform for PAS and many HCBS services (training, registration, and user guides provided by DHHS/Netsmart).
- Therap is the state-mandated system for DD waivers (case management, EVV, and billing).
Billing Process
- PAS/AD/TBI: Providers release matched EVV visits in Netsmart’s Claims Console; unmatched visits must be corrected before release. Manual claims are not allowed.
- DD waivers: Providers bill in Therap, the state-mandated system for DD services.
- Appeals for critical errors: DHHS offers a “Force Pay by State” adjustment request for NOSL/VVER/VIVR/VLOC with documentation; this is not a manual-claim workaround.
Rates
How much does Medicaid pay for home care per hour in Nebraska?
Rates vary by program and service:
- PAS (State Plan Personal Assistance): $3.75 per 15 minutes ($15.00/hour). It should be noted that the state contracts with each agency so while this is the fee schedule, most agencies are paid much more.
- DD waiver examples (effective Jul 1, 2025): Independent Living–Agency $43.74/hour; Independent Living–Independent $25.61/hour; Supported Employment–Agency up to $62.11/hour.
- Day services example (Jan 1–Jun 30, 2025): Adult Day–Agency $10.84/hour.
Overtime/holiday differentials aren’t automatic; follow authorizations, caps, and current fee schedules.
Payers
Nebraska operates Heritage Health managed care (UHC, Nebraska Total Care, Molina) for many benefits; however, long-term care services—including HCBS waivers and State Plan PAS—are excluded from managed care and remain fee-for-service. Non-skilled HCBS providers generally do not need MCO contracts for waiver/PAS lines.
Heritage Health MCOs
- UnitedHealthcare Community Plan of Nebraska
- Nebraska Total Care
- Molina Healthcare of Nebraska
Rates
Payers
Frequently Asked Questions
Most states operate Medicaid waiver or community-based care programs that allow reimbursement for non-skilled services such as personal care, homemaker services, respite care, and attendant care. These programs are often administered through Home and Community-Based Services (HCBS) waivers, aging programs, disability waivers, or managed long-term services and supports (MLTSS) programs. Eligibility criteria, covered services, and billing requirements vary by state.
In many states, yes. Enrolling with the state Medicaid program is typically the first step, but agencies may also need to complete separate contracts, credentialing applications, or network enrollment with individual Medicaid MCOs before claims can be submitted for reimbursement. Requirements vary by state and payer.
Credentialing timelines vary by state and payer, but most home care agencies can expect the Medicaid enrollment and credentialing process to take anywhere from 60 to 180 days. Delays are often caused by incomplete applications, missing ownership documentation, background check issues, or required site visits. Agencies seeking participation with Managed Care Organizations (MCOs) should also account for additional contracting and payer credentialing timelines.
How Paradigm can Help
Paradigm offers a combination of tech and highly skilled people to bridge the gaps in:
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
& Eligibility
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
Credentialling
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
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