What is the difference between authorized hours and scheduled hours?
Authorized hours are what the state or plan approved for the client. Scheduled hours are what you put on the calendar. You can only bill up to the authorized amount, so schedule inside it. CMS lists billing more units than the plan allows as a common error that leads to improper payment.
Think of authorized hours as the client’s budget and scheduled hours as how you spend it.
Authorized hours (or units) come from the approved plan of care or service authorization. They tell you how much of a service Medicaid will pay for, and often on what days or in what period.
Scheduled hours are the visits you assign to caregivers.
Why the gap matters:
- If you schedule more than is authorized, the extra time may not be paid.
- CMS lists "billed units exceed the units authorized in the person-centered plan" as a common error in its improper payment fact sheet.
- Scheduling far less than authorized can mean the client does not get the care approved for them.
Good habits:
- Enter each client’s authorized amount and dates when the authorization arrives.
- Check the schedule against it each week.
- Watch the running balance for each client, so you see a problem before the last week of the period.
- Keep the paperwork that shows the authorization.
In Georgia, if you cannot see an authorization in the EVV system, your administrator should ask the DCH EVV Program team at evv.medicaid@dch.ga.gov.
How CareBravo® helps
The claim is built from checked shifts, so what you bill follows what your caregivers actually worked.
Sources
- HCBS Common Errors: Improper Payment Fact Sheet · CMS
- EVV Common Provider Issues and Support Cheat Sheet · Georgia DCH
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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