Current medicaid hrly rate for lpn pvt duty nursing in queens, ny

  1. Does anybody know how much can an LPN get for home care as a participating provider in the New York Medicaid Program in the county of Queens? I have been calling Medicaid offices in all five boroughs of NYC and nobody answers the phone, only answering machines ... have left messages but nobody calls me back ... anybody can solve this "mistery"?
    Thank you!
  2. Visit Mariangel24 profile page

    About Mariangel24

    Joined: Mar '09; Posts: 4; Likes: 3
    Pediatric Critical Home Care; from NY
    Specialty: Instructor / Pediatric Critical Homecare


  3. by   OneFlyNurz
    i'm a medicaid provider lpn as well. Im in LI and I don't even know how to get a case, let alone the rates. i work through an agency right now and i'm trying to find out how to get cases. My current pt's mom told me that when she receives her statement it tells her that the agency is being paid $60/hour for the hours that I go there!!! The problem is, i don't know if that's the same rate for an independent contractor, ie. us as medicaid providers. I will keep u posted if I get any info.
  4. by   Mariangel24
    I haven't had any luck finding an answer to the question of how much is the rate for LPNs ... in terms of getting patients, I've seen a few families post adds on under medical/health employment requesting nurses, who are independent medicaid providers, for their children. They were for Manhattan and Brooklyn though, I haven't seen any from Long Island. I would suggest asking your patient's mom if she has an agency that manages the child's care, i.e. all her therapysts, re-certification of the case, etc. (this is not the same agency for which you work, but the agency that provides a case manager for the child). My daughter used to have her case managed by Skip of New York, and when I used to have a hard time finding nurses myself, our case manager would provide me with a list of names and numbers of nurses who were independent providers and I would call them and interview them ... so maybe you can register yourself with agencies like that and make yourself available to parents. You can also place an add on criagslist (but now that I remember I saw one just a few days ago, about an LPN from LI available for homecare, maybe it was you?). It's not really easy to have access to this patients information ... Another thing I thought of is to go to the hospitals directly and try to speak to the social worker in charge of organizing the discharge of these critically ill children and make yourself available. I would bring all my credentials, NPI number, Medicaid number, etc, etc. My daughter was at Schneider Children's Hospital and I remember that they would't discharge her because they couldn't find nurses for her ...
    Good luck!

    Maria E.
  5. by   OneFlyNurz
    thanks for the previous reply! I did see that ad on craigslist too, that wasn't me tho lol. I have been doing research and I got the idea of going to the hospitals this morning so this is something that I'm going to implement by the end of this week.
    As far as the rates go, I found out that it depends on the type of case, and whatever rate medicaid approves varies. My patient's mom told me that the agency I work for gets reimbursed $60/hr for my services, from which I'm only paid $23. As an independent contractor, I was told, u cut out the middle man ie. the agency, and medicaid reimburses you whatever the agency would be paid for the same services rendered. Therefore, i think it is safe to say that there's a good income to be gained from private duty nursing, however there are drawbacks, eg. being responsible for paying your taxes as opposed to having them autmatically withdrawn from your check, and also the fact that it takes quite a while before reimbursements begin! Good luck to everyone and thanx again for the info.
  6. by   Mariangel24
    It is my understanding that Medicaid has a flat rate for private duty nursing in the five boroughs (one for RNs and one for LPNs) regardless of what type of case it is, then again, I might be wrong ... I'm yet to read the manual on how to do the billing ... I assume they must have codes for us to use, etc ... I just applied for another number they provide for electronic billing which is supposed to expedite the whole process ... the application has to be notarized and what's not ... paper work, paper work, paper work! Please share updates on how it turns out for you, would ya? Thank you. Good luck!
  7. by   Mariangel24
    Hello there, LI nurse! I have contact information that may be of interest to you for some private homecare cases. If you are still looking please e-mail me privately at and write HOMECARE IN LI on the subject line, so I'll know it's you. Bye.
    Maria E.
  8. by   mel p
    Does any body know of any nursing homes, hosptials or agencies that hire gpn's in the new york city area?
  9. by   nycrncares
    Hi everyone

    How do I become medicaid provider certified? Where can I get the paper work. I'm from Long Island as well
  10. by   GoosbyLPN
    How do i get certified as a LPN to do medicaid cases in GA?
  11. by   BrownOcean
    I would like to be a medicaid provider also. I start school in a few weeks but I would like to get as much information as I can so I know what to do when I'm done.
    Thanks in advance
  12. by   OneFlyNurz
    For NY check out, all the info is there for "Private Duty Nursing"
  13. by   Lisa1203
    The rates in NY for an LPN are $23 - HOWEVER - you can apply for approval for experience with medically fragile children & receive a 30% increase in your wage - that's $31.79/hr. I do not know the RN salary other than that it is higher & RN's can also apply for the 30% increase. Once you get approval use the #7 when you file your claims under "exception code". I know most of you may have no idea what I'm talking about - i'm just trying to show that it's totally worth it financially - but that there are many steps to take. But cutomer service is always available - i've called emedny about 100 times. Here's the website for NY - to begin getting your medicaid provider number. (First you have to obtain an NPI number - but you do that thru this website as well).
  14. by   AreN2010
    This is my first reply ever to lets hope I get it right.

    I graduate in May as an RN from a 4 year program. I was looking to get a Medicaid Provider number so that I am able to get a couple of Private Duty cases in Pediatrics after I graduate.

    I am a little confused because on the Emedny site it stated that you cannot get a provider number if you work in a providers office or a hospital? So you cannot hold a "second job" in the state of New York? Is someone able to clarify this for me? And also...does anyone know what the fee schedule is for RN Private duty cases?