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Personal Care Services (PCW)

 

Prior Authorization Requirements

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Important Updates from the Prior Authorization Department!

Effective 7/15/2026, iCare will require Electronic Visit Verification (EVV) for all live-in caregivers for service code T1019 (Personal Care Services) in the SSI, BadgerCare, and FCP programs. 

and

 

Effective 7/15/2026, iCare will require all initial and renewal Personal Care Worker (PCW) service requests statewide in the iCare SSI or BadgerCare programs that request three or more hours per day to include a personal needs assessment prior to submitting the Prior Authorization.

PCW Personal Needs Assessment Frequently Asked Questions (FAQs)

For selected iCare SSI or BadgerCare+ enrollees residing WITHIN Kenosha, Milwaukee, Ozaukee, Racine, Washington and Waukesha counties, this personal needs assessment must be conducted by Holistic Home Health Care or Independence First.

Holistic Home Health Care

Email: Tessa.Decker@Holistichh.com



Phone Support: 414-231-3130

Holistic Home Health Care Referral Form for Personal Needs Assessment

 

Independence First

Email: IC_Assessments@IndependenceFirst.org 
or copy this address:  IC_Assessments@IndependenceFirst.org

Phone Support: 414-291-7520

Independence First Referral form for Personal Needs Assessment

 

For selected iCare SSI or BadgerCare+ enrollees residing OUTSIDE OF Kenosha, Milwaukee, Ozaukee, Racine, Washington, and Waukesha counties, this personal needs assessment must be conducted by iCare PCW PNA screeners.

iCare PCW PNA Screeners 

Email: iCarePCWPNA@iCareHealthPlan.org

Phone Support: Local - 1-414-231-3130 or Toll free - 1-855-839-1032

iCare Referral Form for Personal Needs Assessment

 

ForwardHealth requires persons who are requesting authorization for Personal Care (PC) service to complete and submit the Personal Care Screening Tool (PCST) form. Please read these instructions prior to completing the PCST form:

 

PCW Provider Guide and Service Request Process

PCW Provider Guide        PCW Request Process

 

iCare PCW Prior Auth Form & Checklist

PCW PA Fillable Request Form        PCW Provider Fillable Checklist

 

DHS Personal Care Screening Tool (PCST) Form & Instructions

PCST Fillable Form       PCST Instructions

 

EVV Form (f02717) Live-In Worker Identification 

EVV Fillable Form

 

These documents and others can also be found on the Prior Authorization Main Page or Prior Authorizations Documents page.

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