Medicaid Financing for Home Visiting

Medicaid is increasingly being pursued by states as a funding stream for home visiting services to serve more families and support better maternal, infant, and child health. While Medicaid does not cover the full scope of home visiting services, states may seek approval to pay for screening, case management, and family support and counseling provided in the course of home visiting with Medicaid funds. 

Common ways to seek Medicaid coverage for home visiting services are through state plan benefits including Targeted Case Management, Extended Services to Pregnant Women, and EPSDT. Other states are seeking to fund home visiting using Medicaid dollars though section 1115, and section 1913(b) waivers.

However, barriers continue to exist that make it challenging for states to cover home visiting within their Medicaid programs, and funding home visiting through Medicaid remains seriously underutilized.

The Home Visiting Coalition supports legislation that would streamline the accessibility of Medicaid funds to support home visiting and establish a specific benefit to cover evidence-based home visiting.  

Separately, the coalition also advocates with Congress and the Administration for improved coordination and guidance between the Centers for Medicare & Medicaid Services (CMS) and the Health Resources and Services Administration (HRSA), the agencies that oversee Medicaid and MIECHV, to provide states with the guidance and support that they need to braid multiple funding sources to successfully expand home visiting. In June, 2023, the Home Visiting Coalition sent this letter to CMS requesting updated guidance. CMS sent this response to the coalition in August, 2023.