Illinois runs two major home care programs with completely different administrative structures: the Community Care Program (CCP) for adults 60+ through 12 Care Coordination Units under the Department on Aging, and the Home Services Program (HSP) for adults with disabilities through DHS. Both programs share the same upcoming deadline — March 2, 2026, when HHAeXchange becomes the EVV aggregator for both. HealthChoice Illinois MCOs add a third billing pathway for managed care members.
Illinois Medicaid home care runs on parallel tracks. The Community Care Program is an aging program under IDoA — the authorization pathway runs through a regional Care Coordination Unit, not directly through the state Medicaid office. The Home Services Program is a disability program under DHS with a participant-directed structure where the participant is the employer. Both programs bill through HFS, but with different procedure codes, authorization formats, and administrative contacts.
For agencies operating in both programs, this means two distinct certification and contracting processes, two sets of CCU or DRS relationships, and — until March 2, 2026 — two separate EVV arrangements. After March 2, 2026, HHAeXchange consolidates EVV aggregation for both.
CCP is administered by the Illinois Department on Aging (IDoA) and provides homemaker and home health care services (HHCS) to adults 60 and older who are at risk of nursing home placement. Service authorization flows through 12 regional Care Coordination Units (CCUs) — the CCU in the participant's region determines eligibility, sets authorized hours, and issues the authorization that must be in place before services begin.
Provider agencies must be certified as CCP providers with IDoA and contracted with the CCU(s) covering their service area. Claims are submitted to HFS. CCU authorization codes must match across the authorization record, the EVV record, and the claim.
HSP is administered by the DHS Division of Rehabilitation Services (DRS) and provides personal assistant services to adults with disabilities who are at risk of nursing home admission. HSP uses a participant-directed model — the participant is the employer of their personal assistant, and the agency's role is primarily fiscal intermediary or support functions rather than traditional agency-directed care.
DRS authorizes HSP services and determines the service plan. Agencies operating in the HSP space must work through DRS for authorization and comply with the participant-employer relationship structure that distinguishes HSP from CCP.
HealthChoice Illinois is the managed care program covering the majority of Illinois Medicaid members. Each MCO within HCI has its own credentialing, prior authorization, and claims submission requirements. Agencies must enroll with HFS as a Medicaid provider AND credential separately with each MCO they intend to bill.
Current HealthChoice Illinois MCOs include Aetna Better Health of Illinois, Blue Cross Community Health Plan, CountyCare Health Plan (Cook County only), Meridian Health Plan, and Molina Healthcare of Illinois. Verify the active MCO list and county coverage map with HFS before contracting, as plan participation varies by county and can change. Each plan's credentialing timeline is independent of the others.
MMAI is Illinois's integrated program for dual-eligible individuals. Like HCI, MMAI MCOs have their own credentialing and claims processes and require separate agency contracts. EVV requirements apply to MMAI services the same as they do for HCI services.
For agencies billing MMAI MCOs, verify the current list of active plans with HFS. MMAI plan rosters have changed over time and the current participating plan list should be confirmed before contracting efforts begin.
March 2, 2026 — CCP and HSP EVV go-live with HHAeXchange. All Illinois Department on Aging (CCP) and DHS Division of Rehabilitation Services (HSP) provider agencies must have HHAeXchange portal setup completed and EVV data flowing to HHAeXchange as the statewide aggregator by this date. Agencies using third-party EVV vendors must have API/EDI integration with HHAeXchange completed. This is a firm date — non-compliant agencies will have EVV records unmatched against claims, triggering holds and denials.
HHAeXchange has been Illinois's statewide EVV aggregator and state-sponsored platform since 2022. Home health services for HFS/Medicaid State Plan, DDD, and HealthChoice MCO providers have been live on HHAeXchange since December 31, 2023. The March 2, 2026 date specifically extends this to the IDoA (CCP) and DRS (HSP) programs, which had EVV standards prior to HHAeXchange's adoption but were not yet aggregating through the state-level HHAeXchange system.
DHS Division of Developmental Disabilities PCS within waiver programs began EVV through HHAeXchange.
Home health services billed to HFS, HealthChoice Illinois MCOs, and MMAI MCOs went live with HHAeXchange EVV requirements.
Every CCP and HSP agency must have HHAeXchange portal setup complete and EVV data transmitting to HHAeXchange. Agencies using third-party EVV vendors must have API/EDI integration testing completed. Register for the HHAeXchange Provider Enrollment Form at hhaexchange.com/info-hub/illinois-doa-drs if not yet registered. DRS contact: [email protected]. IDoA contact: [email protected].
Illinois uses an open choice model: agencies may use the state-sponsored HHAeXchange portal at no cost, or their own preferred EVV vendor as long as that vendor integrates with HHAeXchange. The key requirement for third-party vendors is successful completion of the EDI/API integration process. Contact HHAeXchange at the Illinois provider helpline (1-833-961-7429) for integration support.
Illinois billing for CCP and HSP requires three matching records per visit before a claim will process: the CCU or DRS authorization, the HHAeXchange EVV visit record, and the claim submitted to HFS or the MCO. A mismatch between any of these three — wrong procedure code, authorization period expired, EVV record not yet transmitted to HHAeXchange — creates a billing exception. Illinois personal care rates typically range from $21 to $24 per hour depending on waiver type and payer. Some waivers and MCOs reimburse higher rates for specialized services.
| Program / Payer | Authorization Source | Where Claims Go | EVV Platform |
|---|---|---|---|
| CCP — FFS Medicaid | Regional CCU | HFS (IMPACT billing system) | HHAeXchange (go-live March 2, 2026) |
| HSP — FFS Medicaid | DHS/DRS service plan | HFS (IMPACT billing system) | HHAeXchange (go-live March 2, 2026) |
| HFS Medicaid State Plan Home Health | HFS prior authorization | HFS | HHAeXchange (live since Dec 31, 2023) |
| HealthChoice Illinois MCOs | MCO prior authorization | Each MCO directly | HHAeXchange (live since Dec 31, 2023); MCO authorization codes must match EVV |
| MMAI MCOs | MCO prior authorization | Each MCO directly | HHAeXchange |
| DDD Waivers | DHS/DDD authorization | IMPACT system | HHAeXchange (live since September 2023) |
For HealthChoice MCO claims, the authorization code format includes a payer suffix — CCP authorizations display as the base code (e.g., S5130) while MCO authorizations from IDoA display with a ":DOA" suffix (e.g., S5130:DOA). Mismatching these codes is a common exception trigger. Verify with HHAeXchange documentation that your EVV system is using the correct code format for each payer.
CCP authorization comes from the regional Care Coordination Unit (CCU) in the participant's county. Illinois has 12 CCUs. The CCU assesses the participant, determines eligibility and authorized service hours, and issues the authorization. Agencies must be contracted with the CCU covering their service area — being certified with IDoA as a CCP provider is necessary but the CCU contract is the working relationship. The CCU is also the first contact point for authorization disputes, care plan changes, and service questions. IDoA's central office (217-785-2870) can direct you to the appropriate CCU for a given county.
All CCP (IDoA) and HSP (DRS) provider agencies must complete HHAeXchange portal setup before the March 2, 2026 go-live date. If your agency already has an HHAeXchange portal for HFS Medicaid State Plan services, you do not need to register again — the existing portal covers the CCP and HSP integration. If you do not yet have an HHAeXchange portal, complete the HHAeXchange Provider Enrollment Form at hhaexchange.com/info-hub/illinois-doa-drs. If you use a third-party EVV vendor, your vendor must complete API/EDI integration testing with HHAeXchange before March 2 — contact HHAeXchange at 1-833-961-7429 or your vendor directly to verify integration status.
Yes. HFS provider enrollment gives you the right to bill Medicaid — but billing any HealthChoice Illinois MCO also requires a separate credentialing and contracting process with that specific plan. Typical credentialing timelines range from 60 to 120 days per plan. Agencies serving a broad geographic footprint in Illinois may need to credential with 7 or more MCOs to cover all the HealthChoice plans active in their region. Each plan's process, timeline, and documentation requirements are independent of the others. Start credentialing before you have referrals waiting, not after.
CCP serves adults 60+ through an agency-based model with authorization from CCUs under IDoA. HSP serves adults with disabilities through a participant-directed model under DHS/DRS where the participant is the employer. An agency can participate in both, but the certification, contracting, and administrative relationships are entirely separate — IDoA and CCUs for CCP, DHS/DRS for HSP. The EVV requirement (HHAeXchange, March 2, 2026) and HFS billing pathway apply to both, but the authorization sources, procedure codes, and care plan processes differ between programs.
Illinois agencies managing CCP CCU authorizations, HSP DRS service plans, HealthChoice MCO credentialing and billing, MMAI claims, and the March 2026 HHAeXchange EVV integration are running multiple disconnected administrative tracks simultaneously. CareBravo delivers scheduling, HHAeXchange-integrated EVV compliance, billing across CCP/HSP FFS and MCO-direct pathways, and authorization tracking as completed work. The three-record matching requirement (CCU authorization + EVV record + HFS claim) is managed within the system rather than reconciled manually between separate billing and EVV tools.
Illinois agencies that haven't completed HHAeXchange portal setup or API integration by March 2 will have unmatched EVV records against live claims — which means billing holds. The CareDrain Diagnostic shows what your current operational gaps are costing in monthly revenue terms, and whether EVV compliance is part of the picture.