How to Become a Medicaid Home Care Provider in West Virginia

West Virginia Medicaid — managed by West Virginia Department of Health and Human Resources (DHHR) — Bureau for Medical Services

West Virginia Medicaid at a Glance

Program Name

West Virginia Medicaid

Managing Agency

West Virginia Department of Health and Human Resources (DHHR) — Bureau for Medical Services

Reimbursement Rates

$15–$22/hour for personal care; $42–$78/visit for skilled nursing

Application Timeline

60–90 days

Enrollment Process: Step by Step

  1. 1

    Apply through WV Medicaid Provider Enrollment

  2. 2

    Complete BMS Provider Application

  3. 3

    Submit NPI, EIN, and WV business registration

  4. 4

    Complete WV State Police background checks

  5. 5

    Obtain OHFLAC Home Health Agency License

  6. 6

    Submit liability insurance documentation

  7. 7

    Contract with WV Medicaid managed care plans

Accepted Provider Types

Home Health Agencies Personal Care Providers HCBS Waiver Providers

Required Certifications & Licenses

  • OHFLAC License
  • NPI Number
  • WV State Police Background Check

Waiver Programs in West Virginia

These Medicaid waiver programs fund home and community-based services in West Virginia:

Aged & Disabled Waiver (ADW)

Intellectual/Developmental Disabilities Waiver

Traumatic Brain Injury Waiver

Billing System

Gainwell Technologies — WV MMIS + MCO billing

⚠️ Common Denial Reasons

  • Missing OHFLAC license
  • Background check delays
  • Incomplete application

💡 Tips for Approval

  • WV has significant home care needs in rural Appalachian areas
  • ADW is the primary home care waiver
  • OHFLAC licensure required before enrollment
  • Limited provider competition in many areas

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Frequently Asked Questions — Medicaid in West Virginia

How do I become a Medicaid provider in West Virginia?

To enroll as a Medicaid home care provider in West Virginia, you must apply through West Virginia Department of Health and Human Resources (DHHR) — Bureau for Medical Services. The process includes: Apply through WV Medicaid Provider Enrollment. Timeline: 60–90 days.

What are the Medicaid reimbursement rates in West Virginia?

$15–$22/hour for personal care; $42–$78/visit for skilled nursing

What certifications are required in West Virginia?

Required certifications include: OHFLAC License, NPI Number, WV State Police Background Check.

What waiver programs are available in West Virginia?

Aged & Disabled Waiver (ADW); Intellectual/Developmental Disabilities Waiver; Traumatic Brain Injury Waiver

What are common reasons for Medicaid denial in West Virginia?

Missing OHFLAC license; Background check delays; Incomplete application

More West Virginia Home Care Resources

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