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HOME MODIFICATION SERVICES PROVIDER IN PENNSYLVANIA

  • Writer: Fatumata Kaba
    Fatumata Kaba
  • Oct 8
  • 4 min read

IMPROVING ACCESSIBILITY, FUNCTIONAL SAFETY, AND INDEPENDENCE FOR INDIVIDUALS WITH DISABILITIES THROUGH STRUCTURAL HOME ADAPTATIONS

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Home Modification Services in Pennsylvania are Medicaid-funded supports that allow individuals with disabilities, chronic health conditions, or age-related limitations to remain safely in their homes by modifying their physical living environment. These services are available through the state’s Home and Community-Based Services (HCBS) waivers under the Office of Long-Term Living (OLTL), the Office of Developmental Programs (ODP), and Community HealthChoices (CHC) Managed Care Organizations (MCOs).

 

1. GOVERNING AGENCIES

Agency: Pennsylvania Department of Human Services (DHS) – OLTL & ODP

Role: Authorizes home modifications through HCBS waivers and coordinates approvals through Service Coordinators and Administrative Entities.

Agency: Community HealthChoices (CHC) MCOs

Role: Authorize funding for eligible members and coordinate installation vendors for home modifications.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Ensures compliance of Medicaid-funded environmental adaptation services under federal 1915(c) waiver standards.

Agency: Pennsylvania Department of State

Role: Registers provider entities and ensures compliance with business regulations.

Agency: Pennsylvania Department of Labor & Industry – Contractor Registration

Role: Requires home modification vendors to register as home improvement contractors (HIC) under PA law.

 

2. HOME MODIFICATION SERVICES OVERVIEW

These services involve changes to the individual’s residence that enable greater independence and reduce the risk of institutionalization.

Approved providers may deliver:

  • Accessibility Modifications: Wheelchair ramps, widened doorways, roll-in showers, stair lifts, grab bars.

  • Bathroom & Kitchen Adaptations: Lowered countertops, accessible sinks, raised toilets, lever-handle faucets.

  • Safety Enhancements: Non-slip flooring, transfer systems, visual alarms, and environmental controls.

  • Environmental Control Units (ECUs): Smart home or adaptive devices to improve independent living.

  • Project Management: Site evaluations, scope of work documentation, contractor coordination, and post-install inspection.

  • Documentation: Cost estimates, before/after photos, receipts, and Medicaid billing paperwork.

 

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

  • Register your business with the Pennsylvania Department of State.

  • Obtain an EIN from the IRS and a Type 2 NPI.

  • Register with the PA Home Improvement Contractor Program (HIC) under the Department of Labor & Industry.

  • Enroll in PROMISe™ as a Medicaid provider for Home Modifications.

  • Contract with CHC MCOs, and coordinate with ODP/OLTL Service Coordinators or Support Coordinators.

  • Maintain general liability and workers’ compensation insurance.

  • Develop a Home Modification Services Policy & Procedure Manual that includes project workflows, safety protocols, and Medicaid documentation standards.

 

4. PENNSYLVANIA PROVIDER ENROLLMENT PROCESS

Step 1: Form a legal entity, register with the Department of State, and secure EIN/NPI.

Step 2: Register as a PA Home Improvement Contractor (if applicable).

Step 3: Enroll in PROMISe™ under the appropriate provider type/specialty.

Step 4: Submit qualifications to CHC MCOs and/or ODP/OLTL administrative entities.

Step 5: Upload policy documents, cost estimate templates, and staff/vendor credentials.

Step 6: Begin accepting authorized work orders and service authorizations.

 

5. REQUIRED DOCUMENTATION

  • Business registration and Articles of Incorporation

  • EIN and NPI confirmations

  • PA HIC Registration Certificate

  • Liability and workers’ comp insurance

  • Home Modification Policy & Procedure Manual including:

    • Client intake and pre-authorization protocols

    • Scope of work development and contractor vetting

    • Equipment and material safety standards

    • Installation oversight and post-completion inspection process

    • Service tracking logs and project notes

    • Billing templates, estimate forms, and completion verification

    • HIPAA compliance, grievance procedures, and incident reporting

 

6. STAFFING REQUIREMENTS

Role: Project Manager / Home Modification Specialist

Requirements: Experience in ADA-compliant design and coordination of accessible construction projects.

Role: Licensed Contractor / Installer

Requirements: PA HIC registration, contractor liability insurance, and experience with Medicaid-approved modifications.

Role: Administrative Coordinator

Requirements: Manages project timelines, cost estimates, billing, and coordination with case managers.

All staff and subcontractors must complete:

  • HIPAA and participant privacy training

  • Safety and OSHA-compliant worksite practices

  • Medicaid billing compliance training (as applicable)

  • Annual credential and license renewals

 

7. MEDICAID WAIVER PROGRAMS

Home Modifications are funded through:

  • Community HealthChoices (CHC): For adults with physical disabilities or aging-related needs

  • Independence, OBRA, and Aging Waivers (OLTL): Environmental adaptations to support safe living

  • ODP Waivers (Consolidated, Community Living, P/FDS):

    • Support for individuals with intellectual/developmental disabilities requiring accessibility-related changes in their homes

  • State Plan (limited): Basic DME-related adjustments when authorized

 

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development

Timeline: 1–2 months

Phase: HIC Registration & Medicaid Enrollment

Timeline: 2–3 months

Phase: Staff/Contractor Vetting & System Setup

Timeline: 30–60 days

Phase: Referral & Project Coordination

Timeline: Begins upon MCO/waiver contract approval and service authorizations

 

9. CONTACT INFORMATION

PA Department of Human Services – OLTL

PA DHS – Office of Developmental Programs (ODP)

PA Home Improvement Contractor Registration

PROMISe™ Medicaid Provider Portal

CHC MCO Contacts:

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PENNSYLVANIA HOME MODIFICATION PROVIDER

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — PENNSYLVANIA HOME MODIFICATION PROVIDER

WCG supports contractors and accessibility service providers in Pennsylvania with the full setup and launch of Medicaid-approved home modification operations.

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Scope of Work:

  • Business registration and Medicaid enrollment

  • HIC registration and insurance compliance guidance

  • Policy & Procedure Manual development and compliance review

  • Scope of work templates, cost estimate forms, and tracking tools

  • Billing documentation and post-installation verification materials

  • Referral-building strategies and relationship development with MCOs, SCs, and AEs

  • Compliance consulting for safety standards, ADA guidelines, and Medicaid audits



Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements. 

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