Transition to 1099/independent contractor

Erica Patterson · Mar 27

Hi everyone,

I'm a Texas-based RN currently working in pediatric home health with 5+ years in the field. I care for a medically fragile child under the STAR Kids Medicaid program and am strongly considering transitioning into independent practice to cut out the agency and retain full reimbursement for my work.

I already have:

• An active Texas RN license

• NPI number

• Professional Liability Insurance

• Experience using CubHub (I plan to continue using this independently)

• A decent understanding of Medicaid CPT codes (e.g., S9123) and the current reimbursement rates for private duty nursing

Right now I'm in the middle of:

• Completing enrollment through TMHP as an independent provider

• Planning to credential with the patient's MCO (STAR Kids — BCBS)

• Figuring out how to coordinate the transition without any gap in services

• Weighing the need for things like a Direct Secure Messaging endpoint or setting up HIPAA-compliant communication without a formal EHR

I'd love to hear from others who've gone independent:

• What did your transition process look like?

• How did you handle the overlap with the agency or coordinate authorization transfers?

• Are you billing Medicaid yourself or using a billing service?

• Any advice on credentialing with private insurance or managing secure documentation?

• Lessons learned or things you'd do differently?

This is something I've been researching and planning carefully, but hearing from others who've walked this path would mean a lot.

Thank you so much!

— Erica