Home Modification Services in Maryland involve making physical changes to a participant’s residence to support their health, independence, and ability to remain safely at home. These services are provided under the Maryland Medicaid Home and Community-Based Services (HCBS) programs, including the Community First Choice (CFC) program and the Developmental Disabilities Administration (DDA) Waivers: Community Pathways, Community Supports, and Family Supports.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid and CFC-funded services including home modifications

Agency: Developmental Disabilities Administration (DDA)
Role: Approves and monitors modifications under its waiver programs

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Provides billing, service tracking, and electronic documentation systems

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal HCBS and waiver service standards

2. HOME MODIFICATION SERVICE OVERVIEW

Home Modification services are intended to:

• Increase accessibility and usability of the home
• Support mobility devices and transfers
• Enhance participant safety
• Allow individuals to remain in their community-based residence

Common types of modifications include:

• Wheelchair ramps and platform lifts
• Stair lifts and grab bars
• Widened doorways or hallways
• Roll-in showers or accessible bathtubs
• Lowered countertops and adjustable-height appliances
• Visual alert systems (e.g., for doorbells, alarms)

NOTE: Modifications must be directly related to the individual’s disability, included in their Person-Centered Plan (PCP), and authorized by the appropriate agency.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Maryland Department of Assessments and Taxation (SDAT)
• Obtain EIN from the IRS and Type 2 NPI
• Hold an active Maryland Home Improvement Commission (MHIC) license or relevant contractor certification
• Apply to become a provider under DDA or Medicaid (CFC) through the ePREP portal or DDA Provider Application Portal
• Maintain general liability insurance and workers’ compensation (if applicable)
• Ensure compliance with ADA, state building codes, and DDA accessibility requirements

4. PROVIDER ENROLLMENT PROCESS

Step 1: Business Setup and Licensing

• Finalize business registration, obtain MHIC license, and gather insurance documentation

Step 2: Apply via DDA Provider Portal or Medicaid ePREP

• Choose “Environmental Accessibility Adaptation” (DDA) or “Home Modifications” (CFC)

Step 3: Submit Required Documentation

• Scope of services, credentials, example proposals, safety protocols, and staff or subcontractor resumes

Step 4: Approval and Authorization

• Begin services only upon PCP authorization and service plan approval
• Maintain documentation and submit claims via LTSS Maryland

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC certificate
• IRS EIN and Type 2 NPI documentation
• Maryland contractor license (MHIC) or equivalent
• DDA or CFC program approval letter

Policy & procedure manual including:

• Work proposals and bid comparison forms
• Pre/post photos and participant consent documentation
• Contractor/subcontractor agreements and credentials
• Safety inspection checklist and project logs
• Emergency protocols and compliance standards
• Privacy, consent, and HIPAA policies

6. STAFFING REQUIREMENTS

Role: Licensed Contractor / Home Modification Specialist
Requirements: Active MHIC license, insurance, understanding of ADA and HCBS accessibility standards

Role: Project Coordinator (optional)
Requirements: Background in accessibility services or care coordination, responsible for timelines and family communication

Training Requirements:

• ADA compliance and home accessibility codes
• Person-centered planning principles
• Risk management and emergency planning
• Confidentiality and HIPAA awareness
• Infection control (for in-home work)

7. MEDICAID WAIVER SERVICES

Home Modification services are covered under:

• Community First Choice (CFC) – For individuals who meet nursing facility level of care
• Community Pathways Waiver – For individuals with more intensive support needs
• Community Supports Waiver – For individuals with part-time or targeted support needs
• Family Supports Waiver – For children under 21 living in the family home
• Self-Directed Services – Participants may use their approved budget to arrange home modifications with approved vendors

Covered elements:

• Assessments to determine modification needs
• Equipment and material purchases
• Permits and labor
• Inspections, training, and follow-up (as needed)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Contractor Licensing
Timeline: 2–3 weeks

Phase: Policy Manual and Application Preparation
Timeline: 2–3 weeks

Phase: DDA or Medicaid Enrollment Review
Timeline: 6–10 weeks

Phase: Authorization for First Project and Service Delivery
Timeline: Per client referral and approval cycle

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​Maryland Home Improvement Commission (MHIC)
Website: https://www.dllr.state.md.us/license/mhic

​LTSS Maryland (for waiver billing)
Website: https://ltss.health.maryland.gov

​Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

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10. SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• MHIC licensing and DDA/CFC enrollment
• Policy & procedure manual tailored to accessibility work
• Templates for work orders, family authorization, and safety inspection
• Staff and subcontractor credentialing logs
• Referral coordination tools and intake packets
• Pre/post inspection checklists and before/after photo protocols
• Secure billing preparation tools for LTSS Maryland
• Website and client communication system setup