Arizona - Homemaker Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Arizona, Homemaker Services are overseen by the Arizona Health Care Cost Containment System (AHCCCS) and are enrolled under Provider Type 37 (Homemaker). The service is primarily funded through the Arizona Long Term Care System (ALTCS) waivers to provide general household support for individuals unable to perform these tasks themselves.

To become an approved provider, agencies must enroll through the AHCCCS Provider Enrollment Portal (APEP). While there is no distinct state license required specifically for homemaker agencies, providers must meet AHCCCS standards, including mandatory CPR and First Aid certifications for staff, and must maintain specific documentation such as letters of reference.

1. Service Definition and Scope

Homemaker Services in Arizona provide general household support to individuals who cannot perform these tasks independently. This includes meal preparation, laundry, shopping, and light housekeeping.

The service is designed to maintain a safe and healthy living environment for the member, preventing the need for institutionalization.

• Provider Type: 37 (Homemaker)
• Mandatory Category of Service: 23 (Homemaker)
• Optional Categories: Respite Care (26), Attendant Care (28), Personal Care Service (39)
• Scope: Meal preparation, laundry, shopping, light housekeeping

2. Regulatory and Oversight Agencies

The primary oversight agency for Medicaid services in Arizona is the Arizona Health Care Cost Containment System (AHCCCS). They manage provider enrollment, policy, and billing.

Providers must also interact with Managed Care Organizations (MCOs) that administer the ALTCS program.

• Medicaid Agency: Arizona Health Care Cost Containment System (AHCCCS) (https://www.azahcccs.gov/)
• Enrollment Portal: AHCCCS Provider Enrollment Portal (APEP) (https://www.azahcccs.gov/PlansProviders/APEP/)
• Policy Manual: Provider Enrollment Policy Manual (PEPM) (https://pepm.azahcccs.gov/PEPM/index.html)

3. Gatekeeping Prerequisites: Who Can Even Apply

Arizona does not require a specific state license to operate a Homemaker agency. However, providers must meet AHCCCS enrollment requirements and be approved as Provider Type 37.

There are no Certificate of Need (CON) requirements or mandatory prior-approval letters from regional offices to apply for this provider type.

• Licensure: No specific state license required for Provider Type 37
• Enrollment Type: Facility/Agency/Organization (FAO) or Individual
• Network Access: Open enrollment through APEP, followed by contracting with ALTCS MCOs

4. Licensure and Certification Requirements

Because there is no distinct state license for Homemaker agencies, approval is based on meeting AHCCCS provider qualifications.

Providers must ensure that all staff meet specific certification requirements before delivering services.

• CPR Certification: Mandatory for all staff providing services
• First Aid Certification: Mandatory for all staff providing services
• References: Three letters of reference from non-family persons required
• Record Keeping: Owner/provider must maintain CPR cards, First Aid certificates, and reference letters on file

5. Medicaid Provider Enrollment

All new providers must enroll using the AHCCCS Provider Enrollment Portal (APEP). Paper applications are no longer accepted except in extenuating circumstances.

Providers must select the correct enrollment type (e.g., FAO or Individual) and submit all required documentation through the portal.

• System: AHCCCS Provider Enrollment Portal (APEP)
• Provider Type: 37 (Homemaker)
• Screening Tool: Provider Enrollment Screening Glossary (PEP-903)
• Application Fee: Required based on risk category (refer to PEP-903)

6. Staffing, Training and Background Checks

Staff providing Homemaker services must meet basic competency and background requirements to ensure member safety.

Agencies are responsible for verifying and maintaining documentation of these qualifications.

• Background Check: Fingerprint-Based Criminal Background Check required
• Training: CPR and First Aid certification
• Supervision: Conduct at least one supervisory visit per AHCCCS requirements
• References: Three non-family reference letters per employee

7. Documentation, Policies and Records

Providers must maintain comprehensive records of staff qualifications and service delivery.

AHCCCS requires providers to sign an attestation that all required staff documentation is kept on file and available upon request.

• Staff Records: CPR cards, First Aid certificates, reference letters
• Service Records: Documentation of tasks performed (meals, laundry, etc.)
• Supervisory Records: Logs of supervisory visits
• Attestation: Signed agreement to maintain and provide records upon request

8. Billing, Rates and Claims

Homemaker services are billed as Fee-For-Service (Reimbursement Type 02) or through contracted MCO rates.

Providers must use the appropriate procedure codes and modifiers as specified in their MCO contracts or AHCCCS fee schedules.

• Reimbursement Type: 02 (Fee for Service)
• Billing System: AHCCCS MMIS or MCO portals
• Rates: Determined by AHCCCS fee schedule or MCO contracts
• Group Biller: Option available for organizations acting as financial representatives

9. Approval Sequence and Timeline

The enrollment process begins with submitting an application through APEP. AHCCCS conducts screening activities based on the provider's risk level.

Once approved by AHCCCS, providers must then contract with ALTCS MCOs to receive referrals and authorizations.

• Step 1: Gather required documentation (CPR, First Aid, references)
• Step 2: Submit application via APEP
• Step 3: AHCCCS screening and risk assessment
• Step 4: MCO contracting and credentialing

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incomplete documentation or selecting the wrong enrollment type in APEP.

During audits, providers often face findings related to missing staff credentials or inadequate service documentation.

• Enrollment Errors: Incorrect provider type or enrollment type selected in APEP
• Missing Documents: Failure to upload required CPR/First Aid certificates or reference letters
• Background Checks: Incomplete or failed fingerprint-based background checks
• Audit Findings: Lack of documentation for supervisory visits

11. Key Contacts and Resources

Providers should utilize AHCCCS resources and the APEP system for enrollment and policy guidance.

The AHCCCS Solutions Center is available for specific inquiries and technical assistance.

• AHCCCS Main Website: https://www.azahcccs.gov/
• AHCCCS Provider Enrollment Portal (APEP): https://www.azahcccs.gov/PlansProviders/APEP/
• Provider Enrollment Policy Manual: https://pepm.azahcccs.gov/PEPM/index.html
• AHCCCS Solutions Center: https://servicenow.azahcccs.gov/gsp

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