Home Health Agencies

A Home Health Agency is an agency providing Skilled Nursing Services and at least one (1) of the following other therapeutic services in the place of residence used as the patient’s home:

Physical Therapy
Speech Language Pathology
Occupational Therapy
Medical Social Services
Home Health Aide Services

To establish Centers for Medicare/Medicaid Services (CMS) Medicare certification of an HHA, an applicant must request, complete, and submit an application packet. Application materials are located below or can be requested by contacting the Idaho Bureau of Facility Standards (BFS) at 208-334-6626.

In accordance with the Streamlined Facilities Licensing and Inspection Act, effective July 1, 2025, Medicare Certified Home Health Agencies are no longer required to be licensed in the State of Idaho. No new licenses will be issued after July 1, 2025. Please review the updated Idaho Statute for more information.

Medicare Provider Application and Certification Process

Prior to referring to the information below, please take time to review the CMS Enrollment and Certification Roadmap for better understanding of the certification process.

The following list includes items that must be emailed to Licensing and Certification to be reviewed and approved prior to an initial survey:

Health Insurance Benefits Agreement - CMS 1561 Form.
Fiscal Year Ending form.
Home Health Agency Survey and Deficiencies Report - CMS 1572a Form (complete sections 1-22).
CMS requires all new applicants for HHAs to complete the form CMS-855A, Medicare Application for Health Care Providers that will Bill Fiscal Intermediaries, and forward it to the Regional Home Health Intermediary (RHHI). This may be accomplished either by submitting a hard copy or emailed. Submit the hard copy to the Idaho RHHI at: National Government Services
Provider Enrollment, P.O. Box 7143, Indianapolis, IN 46207-7143; or email the form. The internet-based Provider Enrollment, Chain, and Ownership System (PECOS) may be used in lieu of the Medicare enrollment application (i.e., paper CMS-855A). Information regarding this option may be found at PECOS.
Office of Civil Rights Clearance for Medicare Certification (OCR), This compliance may be completed and submitted online via the Assurance of Compliance Portal.. The submission will go directly into the OCR intake queue, and the provider will receive an email from OCR stating that the provider completed the civil rights submission. The e-mail will contain an OCR number, which is critical to OCR’s ability to access the provider’s submission from the OCR intake queue. The provider will submit a copy of this e-mail to the SA, and the SA will submit it to the CMS Regional Office in lieu of the completed civil rights package.

Become a Medicaid Provider

To become an Idaho Medicaid provider, you must submit an Idaho Medicaid Provider Enrollment application to Gainwell, Idaho’s Medicaid Management Information Systems (MMIS) vendor. To submit an Idaho Medicaid provider enrollment application, go to www.idmedicaid.com and register for a trading partner account. A step-by-step user guide can be found by selecting Reference Material, User Guides, New Provider Enrollment Guide. Additional provider enrollment help is available by contacting your Provider Relations Consultant or Provider Services. Contact information can be found at www.idmedicaid.com or call 866-686-4272.

Applying to be an Idaho Medicaid provider is a separate process from federal certification and state licensure.

Medicare/Medicaid reimbursement is not retroactive and usually becomes effective only after your enrollment application is approved, the initial survey is completed, and you are in compliance with all regulations or have submitted an acceptable plan of correction.