How to start a private duty nursing agency in Arizona

Arizona requires a Home health agency license (ADHS) with Medicare certification preferred; independent RNs may also enroll from AHCCCS (Arizona Medicaid); home health agency licensing by ADHS to operate a private duty nursing agency.

License required

Yes

License

Home health agency license (ADHS) with Medicare certification preferred; independent RNs may also enroll

Issuing agency

AHCCCS (Arizona Medicaid); home health agency licensing by ADHS

Regulation

AHCCCS Medical Policy Manual 1240-G; AMPM 310-I

1. Choose the provider route: Medicare-certified HHA, state-licensed HHA (only where a certified HHA is unavailable), or independent RN
2. Register with AHCCCS and contract with the member's health plan
3. LPNs must be employed by a home health agency and supervised by an RN or physician
4. Independent RNs supply employment references and complete a record-keeping orientation before serving members

Staffing

• RN or LPN per 42 CFR 440.80
• LPN services require RN or physician supervision and HHA employment

Program

Arizona Health Care Cost Containment System (AHCCCS)

Enrollment portal

AHCCCS Provider Enrollment Portal (APEP)

Fiscal agent

None — AHCCCS runs provider enrollment and its own claims system in-house

Application fee

AHCCCS charges the enrollment fee to non-individual provider types at enrollment and can charge it again at revalidation; AHCCCS lists $750 for calendar year 2026, matching Medicare's fee. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

AHCCCS requires the fingerprint-based criminal background check (FCBC) only for high-risk provider types. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

AHCCCS applies site visits to moderate- and high-risk provider types, at enrollment and at revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

AHCCCS requires revalidation every four years (stricter than the federal five) and may call for off-cycle revalidation; providers get 90 days from notice or their enrollment is terminated. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Arizona Medicaid enrollment guide →

CON program

No

Agency

Arizona Department of Health Services (ambulance certificates of necessity only)

Arizona certificate of need details →

Model

hybrid

State vendor

AHCCCS Aggregator (state-run); Sandata was the statewide vendor until 2025-09-30

Services in scope

• personal care
• home health
• attendant care
• homemaker
• habilitation
• respite

Alternate EVV allowed

Yes

Program

https://www.azahcccs.gov/AHCCCS/Initiatives/EVV/

Arizona EVV requirements →

State minimum wage

$15.15 an hour

Effective

2026-01-01

Scheduled increases

Rises to $15.65 on 2027-01-01 (annual CPI adjustment announced by the Industrial Commission).

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Nursing care agencies (private duty nursing) — active organization NPIs (NPPES)

163 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,611,827 (as of Jun 1, 2026)

All Arizona Private duty nursing Medicaid rates, ranked →

• Arizona Long Term Care System (ALTCS) — AHCCCS Section 1115 demonstration (1115)

Arizona waivers and waiting lists →