Personal Care Agency: Initial Certification

Contact Email

Phone

608-266-2702

Fax

608-264-9847
DHS/DQA/BHS
Attn: PCA Certification
P.O. Box 2969
Madison, WI 53701-2969

The personal care agency (PCA) application process is for any individual, tribe, county department, or independent living center intending to provide only personal care services as a free-standing agency, to individuals in their place of residence. Personal care services includes assistance with activities of daily living such as bathing, dressing, ambulating, or eating, or accompanying a client to a medical appointment.

Type

Initial

Description

Initial approval of a personal care agency to become Medicaid certified.

Duration

Certification does not expire unless revoked, suspended or a voluntary closure.

Fees

$300.00

WI Administrative Code

Medical Assistance Provider Certification (DHS 105.17) and Covered Services (DHS 107.112)

Additional Information

See Personal Care Agency website for additional information.

Last Revised: April 2, 2018