Home care Medicaid rates in Pennsylvania split sharply by service. The state pays $19.48 an hour for agency personal care on its code W1793 ($4.87 per 15 minutes), which ranks 25 of 27 states and sits 36.2% below the $30.52 national median. Yet daily respite on W9792 pays $548.81, rank 3 of 34 and 126.6% above the national median.
Pennsylvania sits near the bottom of one national ranking and near the top of another. For an agency here, that means the business case depends heavily on which services it delivers. Every rate below is compiled from official state Medicaid publications and linked to its source document.
Pennsylvania bills its main agency personal care service on W1793, a state-specific code, rather than on T1019 alone. At $19.48 an hour, it is third from the bottom nationally. Only Louisiana ($19.08) and Texas ($18.28) pay less.
The top of the ranking is far away. Utah pays $84.84 an hour, Oregon $42.24 and Iowa $42.00. Pennsylvania's W1793 rate has been in effect since 2018-07-01, which makes it one of the older rates still in force among the states we rank.
What this means for a provider: hourly personal care in Pennsylvania leaves little room for anything beyond the aide's pay. Supervision, travel time between clients, training and scheduling have to be funded from a rate that sits well under the middle of the country.
Pennsylvania publishes much of its home care on state-specific W codes alongside national codes such as T1005 and S5102. Each W code is tied to a specific waiver service and provider type, so the code on the claim is what determines the rate, not the description of the task.
Units
- 15-minute units for personal care (W1793), hourly respite (T1005) and companion care (W1726). The hourly figures in this article are four units.
- Day units for daily respite (W9792).
- Half-day units for adult day services on S5102.
Unit choice is where Pennsylvania agencies win or lose. The same staff time is paid very differently depending on whether it is authorized and billed as quarter-hours or as a day.
The rest of Pennsylvania's home care schedule is uneven.
| Service | Code | Pennsylvania rate | Rank | vs national median |
|---|---|---|---|---|
| Personal care (hourly) | W1793 | $19.48 an hour | 25 of 27 | -36.2% |
| Respite care (hourly) | T1005 | $17.96 an hour | 34 of 38 | -29.0% |
| Respite care (daily) | W9792 | $548.81 a day | 3 of 34 | +126.6% |
Daily respite is the standout. At $548.81 a day, Pennsylvania trails only Minnesota ($938.09) and Missouri ($623.73). At the bottom, New Mexico pays $73.09 and New Hampshire $34.04. The W9792 rate has been in effect since 2017-07-01.
Hourly respite on T1005 pays $4.49 per 15 minutes, or $17.96 an hour, near the bottom of 38 ranked states. Virginia leads at $74.04 and the lowest is Indiana at $14.00.
Pennsylvania also publishes a companion rate on W1726 of $5.72 per 15-minute unit, effective since 2024-10-01, and an adult day rate on S5102 of $37.51 per half day. Neither is ranked in the national comparison.
The gap between the two respite formats is the most important pricing fact in Pennsylvania home care. An agency able to deliver respite in full-day blocks is paid at one of the highest levels in the country, while the same service sold by the hour is paid at one of the lowest.
That has practical consequences:
- Care planning. Where a family's needs genuinely call for a full day of relief, the authorization should reflect that, and the agency should be ready to staff it.
- Staffing model. Daily respite works best with aides who can take long, single-client shifts. Agencies built around short visits may need a separate pool for it.
- Mix management. A modest share of daily respite days can offset losses elsewhere in the hourly book.
Daily respite is not a way around the hourly rates; it is a different service with its own authorization. But an agency that ignores it is leaving the best-priced line in Pennsylvania home care to others.
The median wage for home health and personal care aides in Pennsylvania was $14.14 an hour in May 2025, below the $17.21 national median. Registered nurses earned a median of $46.36, close to the $46.90 national figure.
Even with a below-median wage, the hourly rates do not cover a fully loaded aide:
- Personal care at $19.48 an hour: the loaded median wage is 103.2% of the rate, a margin of minus $0.62 an hour.
- Hourly respite at $17.96: the loaded wage is 111.9% of the rate, a margin of minus $2.14 an hour.
So a Pennsylvania agency paying the median aide wage on hourly services is underwater before overhead. Agencies that make the hourly lines work typically do so through volume, lower-cost scheduling or a service mix that includes better-paid lines such as daily respite. Wage pressure is the main risk: any increase in local aide pay deepens the hourly loss unless rates move with it.
Community HealthChoices, the Office of Long-Term Living's home and community-based waiver, runs through Pennsylvania's home care data. Plans named in our data include Keystone First Community HealthChoices, AmeriHealth Caritas Pennsylvania Community HealthChoices, PA Health & Wellness and UPMC Community HealthChoices, and the state data names 18 plans in total.
Pennsylvania's managed-care rules differ by line:
- Personal care: plans must pay at least the published rate, so W1793 acts as a floor in plan contracts.
- Other home and community-based services: plans negotiate, and the published rate applies out of network. For respite and adult day, the fee schedule is the benchmark for contract talks, not a guaranteed floor.
The Pennsylvania managed care page shows the rule for every service line.
Prior authorization
Pennsylvania attaches 1 prior authorization rule to each of the main home care codes in our data, including T1019, T1005, S5102, W1724, W1725, W1726, W1792 and W1793. Every home care hour should trace back to an approved service plan before it is billed.
The changes in Pennsylvania's home care data are waiver actions from the Office of Long-Term Living rather than rate increases with a stated percentage:
- Amendment to the Community HealthChoices Waiver (effective 2026-07-01).
- Renewal of the OBRA Waiver (effective 2026-07-01), the waiver for adults with developmental physical disabilities.
- Medical Assistance Fee Schedule Revisions in the OBRA Waiver and the Act 150 Program (proposed, effective 2026-01-01). Act 150 is the state-funded attendant care program.
- Earlier rounds: a Community HealthChoices renewal and an OBRA amendment effective 2025-01-01.
The fee schedule revision for OBRA and Act 150 is the item to watch for attendant care agencies, since it touches the rate tables directly. Waiver amendments and renewals can also change service definitions and provider requirements without changing a rate, so they deserve a read even when no percentage is attached.
Pennsylvania's position depends on the service. For hourly personal care it sits beside the lowest-paying states; for daily respite it sits beside the highest:
- Texas home care rates are lowest for personal care at $18.28 an hour.
- Louisiana home care rates pay $19.08, just below Pennsylvania.
- Minnesota home care rates lead daily respite at $938.09.
- New Jersey home care rates are the closest neighboring comparison for agencies working the eastern border.
The home care Medicaid rates by state hub covers the national picture.
Budgeting. Forecast by code and unit, not by blended hourly revenue. Separate the hourly book (W1793, T1005, W1726) from day-based lines (W9792, S5102), because they behave as different businesses.
Contract review. For personal care, check that any Community HealthChoices offer meets the published W1793 rate. For respite and adult day, use the fee schedule as the reference point and ask what the plan pays above it.
Cost control. With hourly margins negative at the median wage, scheduling density matters: fewer unpaid gaps and shorter travel between clients are the levers an agency controls.
Watching changes. Track the OBRA and Act 150 fee schedule revisions, the most likely source of new rates in the attendant care lines.
Rate age. Because W1793 and T1005 have not moved since 2018-07-01, an agency's own costs have drifted further from the rate every year. Recheck the margin annually against current payroll rather than relying on a model built when the rate was set.
Pennsylvania runs one of the deepest schedules in the country: all 49,804 current Pennsylvania Medicaid rates, across 25 programs, with history back to 1983. Home care sits inside several of those programs at once, from Community HealthChoices to the ODP waivers and the Act 150 program. Several of those programs are historical waivers that were folded into Community HealthChoices, which is why older claims can carry codes and rates that no longer apply to new authorizations. The Pennsylvania Medicaid rates page covers every service line, and the full dataset includes every W code, modifier and effective date.
Rates on this page are compiled from official state Medicaid publications, including the PA DHS PROMISe Outpatient Fee Schedule and the Office of Long-Term Living waiver notices. Each rate links to its source document. Hourly figures convert 15-minute units at four units per hour, and rankings compare each state's agency rate for the same service. Our methodology explains conversions, provider levels and ranks.