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New York - Homemaker Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In New York, homemaker services—such as meal preparation, laundry, shopping, and light housekeeping—are provided by Licensed Home Care Services Agencies (LHCSAs) under the oversight of the New York State Department of Health (DOH). To bill Medicaid for these services, an agency must first obtain a Certificate of Need (CON) and LHCSA licensure from the Public Health and Health Planning Council (PHHPC) and DOH, and then enroll in the New York Medicaid program.

Currently, the most significant structural gatekeeping mechanism is a statewide Medicaid enrollment moratorium. As of July 2026, the DOH has frozen all new Medicaid provider enrollments for LHCSAs (Category of Service 0264) through at least January 27, 2027, meaning no new LHCSA Medicaid applications are being processed during this period.

1. Service Definition and Scope

Homemaker services in New York provide general household support for individuals who cannot perform these tasks independently. This includes meal preparation, laundry, shopping, and light housekeeping.

These services are delivered by Licensed Home Care Services Agencies (LHCSAs), which offer home care services to individuals paying out of pocket, through private insurance, or via Medicaid.

2. Regulatory and Oversight Agencies

The primary regulatory body for LHCSAs in New York is the Department of Health (DOH), which oversees licensure and Medicaid enrollment.

The Public Health and Health Planning Council (PHHPC) is responsible for approving the Certificate of Need (CON) required for LHCSA licensure.

3. Gatekeeping Prerequisites: Who Can Even Apply

New York imposes strict gatekeeping prerequisites for LHCSAs. The most critical current barrier is a statewide Medicaid enrollment moratorium for LHCSAs (Category of Service 0264), effective through at least January 27, 2027.

Additionally, before applying for licensure, an agency must obtain a Certificate of Need (CON) from the PHHPC, demonstrating a public need for the service in the proposed area.

4. Licensure and Certification Requirements

To become a LHCSA, applicants must submit a CON application to the DOH. This process involves demonstrating public need, financial feasibility, and character and competence of the operators.

After CON approval by the PHHPC and DOH, the agency must submit its Policy and Procedure Manuals for review before final licensure is granted.

5. Medicaid Provider Enrollment

Once licensed, LHCSAs must enroll in the New York Medicaid program via the eMedNY Provider Services Portal (PSP). However, new enrollments are currently subject to the moratorium.

Providers must pay an application fee and submit various forms, including an Electronic Transmitter Identification Number (ETIN) Certification Statement.

6. Staffing, Training and Background Checks

LHCSAs must ensure their staff meet specific training and background check requirements. Home Health Aides and Personal Care Aides must complete approved training programs.

Agencies are responsible for verifying the credentials and conducting background checks on all direct care staff.

7. Documentation, Policies and Records

LHCSAs must maintain comprehensive documentation, including Policy and Procedure Manuals, which are reviewed by the DOH using specific tools.

Agencies must also submit annual statistical reports, such as the Licensed Home Care Services Agency Statistical Report.

8. Billing, Rates and Claims

Billing for Medicaid services in New York is processed through eMedNY. Providers must use HIPAA-compliant claim formats, such as the 837I or 837P.

Before submitting claims, providers must verify member eligibility using the Medicaid Eligibility Verification System (MEVS) or ePACES.

9. Approval Sequence and Timeline

The approval process begins with obtaining an NPI and Medicare enrollment, followed by the LHCSA CON application. CON approval can take several months.

Once licensed, Medicaid enrollment via eMedNY typically takes up to 45 days for review, though the current moratorium halts new LHCSA enrollments.

10. Common Denials and Survey Findings

Common reasons for application denial include failure to demonstrate public need in the CON application or incomplete Policy and Procedure Manuals.

During Medicaid enrollment, failure to respond to requests for additional information within 45 days will result in the application being withdrawn.

11. Key Contacts and Resources

Providers should utilize the DOH and eMedNY websites for the most up-to-date information on licensure and Medicaid enrollment.

The eMedNY Call Center is available for questions regarding the Medicaid enrollment process.

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