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

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 DQA Personal Care Agency website for additional information.

Last Revised: November 15, 2016