Home Modification Services in Kentucky support individuals with disabilities or chronic conditions by adapting their homes to meet functional needs and ensure safety. These modifications reduce fall risk, enhance mobility, and enable individuals to remain in their communities. Covered under specific Kentucky Medicaid Home and Community-Based Services (HCBS) waivers, home modifications are critical to supporting aging in place and reducing institutional care reliance.

1. GOVERNING AGENCIES

Agency: Kentucky Cabinet for Health and Family Services (CHFS) — Department for Medicaid Services (DMS)
Role: Administers Medicaid reimbursement and enrollment for home modification providers

Agency: Kentucky Department for Aging and Independent Living (DAIL)
Role: Oversees approval standards and waiver criteria for home modifications

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and integration of environmental adaptations into person-centered planning

Agency: Managed Care Organizations (MCOs) under Kentucky Medicaid
Role: Authorizes modifications through PCSPs, credentials vendors, and oversees billing and quality reviews

2. SERVICE OVERVIEW

Home Modification Services involve physical changes to a participant’s residence that enhance accessibility, promote safety, and support independent living.

Approved modifications may include:

• Installation of wheelchair ramps, grab bars, and stair lifts
• Bathroom adaptations: roll-in showers, raised toilets, widened doorways

Kitchen accessibility improvements: lowered counters, accessible appliances

• Widening of doorways or hallways
• Installation of non-skid flooring or handrails
• Voice-activated systems or door alarms (as allowed)
• Structural changes required to accommodate durable medical equipment

All services must be identified in the participant’s Person-Centered Service Plan (PCSP) and justified as medically necessary with supporting clinical documentation.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Kentucky Secretary of State
• Obtain IRS EIN and Type 2 NPI
• Enroll through the Medicaid Partner Portal Application (MPPA) as a home modification provider or vendor
• Maintain general liability and construction-specific insurance ( contractor bonding if applicable)
• Hire or subcontract licensed general contractors, electricians, and plumbers as required
• Develop a Home Modification Services Policy & Procedure Manual
• Ensure compliance with ADA standards, building codes, and safety guidelines
• Implement HIPAA-compliant records for participant information, estimates, and service logs

4. KENTUCKY PROVIDER ENROLLMENT PROCESS

Step 1: Medicaid Enrollment

• Apply through MPPA as a provider of Environmental Accessibility Adaptations or Home Modifications
• Complete MCO credentialing and submit vendor pricing and compliance documentation

Step 2: Documentation Submission

• Submit proof of licensure, insurance, business registration, and sample project scope templates
• Provide written policies for estimates, quality control, and inspection procedures

Step 3: Service Authorization & Completion

• Obtain home assessment or physician recommendation
• Submit modification request to MCO for review and pre-authorization
• Complete project per approved scope
• Submit documentation, photos, and invoice for reimbursement

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Kentucky business license
• IRS EIN and Type 2 NPI verification
• Contractor’s license (or subcontractor agreements)
• General liability and construction insurance

Home Modification Services Policies & Procedures Manual, including:

• Home assessment and estimate templates
• Participant consent and approval forms
• Project scope, timelines, and inspection logs
• ADA and state building code compliance protocols
• Critical incident and repair warranty procedures
• Staff/subcontractor credentials and liability verification
• HIPAA compliance and Medicaid billing documentation

6. STAFFING REQUIREMENTS

Role: Project Coordinator / Home Modification Manager
Requirements: Experience in housing accessibility projects, background check and contractor oversight

Role: Contractor / Licensed Tradesperson
Requirements: Kentucky licensure or certification in applicable trades, insurance and bonding

Role (optional): Occupational Therapist or Accessibility Specialist
Requirements: Provides functional assessments and adaptation recommendations (if required)

All staff and subcontractors must complete:

• HIPAA compliance training
• Safety and construction standards orientation
• Documentation protocols for Medicaid-funded projects
• Background screening and insurance verification

7. MEDICAID PROGRAMS & HCBS WAIVERS

Home Modification Services are reimbursable under:

• Supports for Community Living (SCL) Waiver
• Michelle P. Waiver (MPW)
• Home and Community Based (HCB) Waiver
• Acquired Brain Injury (ABI and ABI-LTC) Waivers
• Model II Waiver (MIIW)

Delivery settings include:

• Participant-owned or rented private residences
• Group homes or supported living arrangements (when authorized)

Note: Modifications must not be for general home improvements or aesthetic upgrades and require clinical or case manager justification.

​

8. TIMELINE TO LAUNCH

Phase: Business Setup and Contractor Agreements
Timeline: 1–2 months

Phase: MPPA Enrollment and MCO Credentialing
Timeline: 60–90 days

Phase: Documentation and Pricing System Development
Timeline: 1–2 months

Phase: Service Authorization and Project Launch
Timeline: Based on MCO approval (typically 30–60 days per project)

​

9. CONTACT INFORMATION

Kentucky Department for Medicaid Services (DMS)
Website: https://chfs.ky.gov/agencies/dms

Medicaid Partner Portal Application (MPPA): https://mppa.ky.gov

Kentucky Department for Aging and Independent Living (DAIL)
Website: https://chfs.ky.gov/agencies/dail

Kentucky Cabinet for Health and Family Services (CHFS)
Website: https://chfs.ky.gov

​

10. SCOPE OF WORK

• Business setup, MPPA enrollment, and MCO credentialing
• Home Modification Policies & Procedure Manual development
• Templates for estimates, inspections, and HIPAA-compliant billing
• Contractor vetting, licensing guidance, and pricing model setup
• Documentation support for reimbursement and MCO audits
• Referral coordination materials for hospitals, therapists, and case managers