I also have, a friend, that is ,checking into, starting a peds,agency here. She called my friend and consulted, with her. she,was told, to sign up with the state, on a couple of clients, to bill thru ,local medicaid. she said, that's all you, have to do. I would if I were you, call your state, and see, if you can, get a billing number, so you can private bill, medicaid or medicare. In Indiana, I know LPNS can, do that, without, an RN because they are here, even for skilled care. you can send me a ,message if you would like. I will call my friend, and see, if she will talk to you, I know she will, she is extra nice, but first, call your state,this week, and see if you can, get any info, on private billing. also keyword, "LPN starting home health agency" in your state. Let me know what, you find out. Are you working anywhere,right now? just curious. GOOD LUCK!