MedicaidCoverageMedium impact
Regulatory Changes Impacting Medicaid PCS
EmblemHealth·NY·Provider News
Effective date
Nov 8, 2021
We identified it
Jun 20, 2026
Summary
New York State regulations now expand Medicaid personal care services (PCS) to include supervision and cueing for Level 1 services (nutritional and environmental support), superseding previous guidance that limited this to Level 2 services only. This change affects billing for Consumer Directed Personal Assistance Program (CDPAP) and PCS services.
Action Required
Immediately: Billing teams in New York should review current Medicaid PCS and CDPAP billing practices to ensure supervision and cueing services for Level 1 nutritional and environmental support functions are being properly billed. Update billing guidelines to reflect expanded allowable services under the new NYSDOH regulations. Consult the NYSDOH website for detailed implementation guidance.