Provider Requirements and Service Limitations

From The May 2010 Florida Medicaid Provider Handbook

Information highlighted in yellow indicates a change since the July 2007 version of this handbook.

Companion - Requirements To Receive


Companion services consist of non-medical care, supervision and socialization activities
provided to an adult on a one-on-one basis or in groups not to exceed three recipients.
This service must be provided in direct relation to the achievement of the recipient’s
goals per his support plan. A companion provider may also assist the recipient with
such tasks as self-care needs, meal preparation, laundry and shopping; however, these
activities shall not be performed as discrete services. This service does not entail handson
medical care. Providers may also perform light housekeeping tasks, incidental to the
care and supervision of the recipient. The service provides access to community-based
activities that cannot be provided by natural or other unpaid supports, and should be
defined as activities most likely to result in increased ability to access community
resources without paid support. Companion services may be scheduled on a regular,
long-term basis.

Companion services are not merely diversional in nature, but are related to a specific
outcome or goal(s) of the recipient. Examples of acceptable companion activities are
volunteer activities performed by the recipient as a pre-work activity; going to the
library, getting a library card, learning how to use the library and checking out books or
videos for personal use; shopping for groceries; or going to an animal shelter to learn
about animals, and volunteering or assisting at the animal shelter.

This service is not available to individuals enrolled on the DD Waiver – Tier Four.


Providers of companion services are limited to the amount, duration, and scope of the
services described on the recipient’s support plan and current approved cost plan. A
recipient shall receive no more than six hours or 24-quarter hour units of these services
per day. A unit is defined as a 15-minute time period or a portion thereof.

A recipient is limited to no more than 30 hours a week of companion services. The unit
value is 15 minutes. Companion services are used to provide a meaningful day activity
for a recipient. A recipient may not receive a combination of ADT, companion or
supported employment services that exceeds 30 hours per week. A recipient may not
receive more than a total of 30 hours a week of a paid support, or combination of paid
supports designed to be used as a meaningful day activity. The companion rate shall be
based on one to three recipients receiving the service during the same time interval.
The rate ratio is determined by what is the usual and customary service delivery pattern
and does not fluctuate with incidental absences of one or more recipients included in
the rate ratio.

Companion services are limited to adults only (21 or older). Recipients may not receive
this service in the provider’s home. This service cannot be provided concurrently (at the
same time) with adult day training, personal care assistance, in-home support services
(quarter hour), supported employment and residential habilitation services.

Documentation Requirements

Reimbursement* and monitoring documentation to be maintained by the provider:

  1. *Copy of claim(s) submitted for payment;
  2. *Copy of service log.

The provider must submit a copy of service log, monthly, to the waiver support

If the provider plans to transport the recipient in his private vehicle, at the time of
enrollment, the provider must be able to show proof of valid: 1) driver’s license, 2) car
registration, and 3) insurance. Subsequent to enrollment, the provider is responsible for
keeping this documentation up-to-date.

*Indicates reimbursement documentation.

Place of Service

Companion services may be provided in the recipient’s own home or family home, or while a recipient who lives in his own home, family home or licensed facility is engaged in a community activity. Companion services provided to a recipient living in a licensed group or foster home must be performed in the community, not the licensed living environment. No service may be provided or received in the provider’s home.

Special Considerations

Companion services are provided in accordance with an outcome on the recipient’s
support plan and are not merely a diversion.

If the provider plans to transport the recipient in his private vehicle, at the time of
enrollment, the provider must be able to show proof of valid: 1) driver’s license, 2) car
registration, and 3) insurance. Subsequent to enrollment, the provider is responsible for
keeping this documentation up-to-date.

Companion services providers are not reimbursed separately for transportation and
travel costs. These costs are integral components of companion services and are
included in the basic rate.

Companion Provider Requirements

Provider Qualifications

Providers of companion services may be home health or hospice agencies licensed in accordance with Chapter 400, parts III and IV, F.S. If providing this service as an agency or group provider, using more than one employee to provide companion services and billing for their services, the provider must be registered as a sitter or companion provider in accordance with section 400.509, F.S. if not licensed as a home health agency or a hospice.

Independent vendors are not required to be licensed, certified, or registered if they bill
for and are reimbursed only for services personally rendered.

Minimum qualifications for a companion include: be at least 18 years of age and have
one year of experience working in a medical, psychiatric, nursing or child care setting, or
in working with recipients having developmental disabilities. College, vocational or
technical training from an accredited institution can substitute at the rate of 30
semester, 45 quarter or 720 classroom hours for the required experience.

Training Requirements

Proof of training in the areas of Cardiopulmonary Resuscitation (CPR), HIV/AIDS and
infection control is required within 30 days of initially providing companion services.
Proof of annual or required updated training shall be maintained on file for review. The
provider is responsible for all training requirements outlined in the Core Assurances.

Note: Refer to the Core Assurances in Appendix A for the provider training