How to start a private duty nursing agency in Wyoming

Wyoming requires a Home health agency license (WDH Healthcare Licensing and Surveys) from Wyoming Department of Health — Healthcare Licensing and Surveys (license); Division of Healthcare Financing (Medicaid) to operate a private duty nursing agency.

License required

Yes

License

Home health agency license (WDH Healthcare Licensing and Surveys)

Issuing agency

Wyoming Department of Health — Healthcare Licensing and Surveys (license); Division of Healthcare Financing (Medicaid)

Regulation

WDH HLS Rules Chapter 9 (Program Administration of Home Health Agencies)

1. Apply to HLS for a home health agency license with the fee and checklist documents; receive a provisional license
2. Once serving clients with two or more services, request in writing an unannounced initial survey; a permanent license issues on compliance
3. Enroll separately in Medicare/Medicaid (a state license does not confer federal certification)
4. For waiver participants, request prior authorization of skilled nursing on the WDH form

Program

Wyoming Medicaid and Kid Care CHIP (Wyoming Department of Health, Division of Healthcare Financing, Office of Medicaid)

Enrollment portal

Discover Your Provider (DyP) provider enrollment portal, run by HHS Technology Group (HTG)

Fiscal agent

CNSI (operates the Benefits Management System claims processing); provider enrollment is contracted to HHS Technology Group (HTG)

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. WDH's enrollment page does not list a separate state fee.

Fingerprinting

WDH says enrolling under a taxonomy considered high-risk can add steps, and a provider specialist will reach out. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. WDH's enrollment page does not describe a separate state site visit process.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. After an April 2026 CMS request, WDH sent CMS a two-year off-cycle revalidation plan on June 5, 2026. Under an August 17, 2026 notice, high-risk providers must revalidate in the DyP portal by October 31, 2026. Every enrolled provider must also report an NPI by then; providers without one are treated as high risk. Missing the deadline means payment suspension, then termination on February 1, 2027.

Full Wyoming Medicaid enrollment guide →

CON program

No

Wyoming certificate of need details →

Model

hybrid

State vendor

CareBridge

Services in scope

• personal care
• companion
• personal support
• respite
• home health aide
• skilled nursing

Alternate EVV allowed

Yes

Program

https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/electronic-visit-verification-evv/

Wyoming EVV requirements →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Nursing care agencies (private duty nursing) — active organization NPIs (NPPES)

15 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

59,335 (as of Jun 1, 2026)

All Wyoming Private duty nursing Medicaid rates, ranked →

• WY Children's Mental Health Waiver (1915(c))
• WY Community Choices Waiver (CCW) (1915(c))
• WY Comprehensive Waiver (1915(c))
• WY Supports Waiver (1915(c))

Wyoming waivers and waiting lists →