Private duty nursing is continuous, one-on-one nursing care in the home — not a scheduled visit that ends after an hour. It exists specifically for people whose nursing needs go beyond what a Certified Home Health Agency (CHHA) is set up to provide.
How it’s different from a visiting nurse
Per New York State’s Medicaid policy on private duty nursing, a CHHA generally provides nursing on a part-time or intermittent basis — typically fewer than two hours per visit. Private duty nursing is for people who need more individual and continuous nursing care than that: longer shifts, sometimes around the clock, from a nurse focused on one patient rather than moving between several.
| CHHA visiting nurse | Private duty nursing | |
|---|---|---|
| Typical visit length | Under 2 hours | Extended shifts, sometimes continuous |
| Who it serves | Patients needing periodic skilled tasks or monitoring | Patients whose needs exceed what periodic visits can cover |
| Nurse’s caseload | Multiple patients per day | Focused on one patient for the shift |
Who can provide it
Only two categories of provider are permitted: a licensed home care services agency enrolled as a Medicaid provider, or a privately practicing RN or LPN who is individually Medicaid-enrolled. An LPN providing private duty nursing must do so in compliance with Article 139 of the New York Education Law, which for an independently practicing LPN generally means working under a physician’s oversight — an LPN doesn’t practice privately the way an RN can.
Getting it through Medicaid: the approval process
Private duty nursing through Medicaid requires prior approval before it starts. In practice:
- A physician or nurse practitioner writes the order. It has to describe why the service is medically necessary, how often it’s needed, whether the case calls for an RN or an LPN, and the specific number of hours recommended.
- The request goes to the state or the local district for review. Most social services districts have the New York State Department of Health review prior-approval requests directly; a handful of districts — Broome, Chemung, Erie, Oneida, Schenectady, Tompkins and Westchester — process their own.
- A fully documented request is generally decided within 21 days. That’s the state’s own regulatory target (10 NYCRR § 85.37), not a guarantee — incomplete paperwork is the most common cause of delay.
- Approval runs in increments, not indefinitely. Private duty nursing is typically authorized for up to six months at a time, with recertification required to continue past that.
Most new cases start at hospital or nursing facility discharge, where the discharge planner refers the patient into private duty nursing as part of the discharge plan. Someone already living at home can also request it — the client or their representative can start the process directly with their physician.
What if you can’t find a Medicaid-enrolled provider willing to take the case
Not every enrolled provider has capacity for every case. If nobody has room for the full recommended hours, more than one provider can be used to split the coverage. A list of Medicaid-enrolled private duty nursing providers is available through the Medicaid Helpline at 1-800-541-2831.
The private-pay alternative
Medicaid private duty nursing is a specific, documented, approval-gated pathway — it exists for people who qualify for Medicaid and can get through the prior-approval process. Families who are not on Medicaid, or who need nursing coverage faster than the approval process allows, can also arrange private duty nursing directly through a licensed agency, paid privately, without the same paperwork cycle.
We provide private duty nursing and skilled nursing visits through RNs and LPNs across Brooklyn and Queens — for medication management, wound care, tracheostomy and ventilator support, and other needs that go beyond what a home health aide is trained or licensed to do. If you’re weighing the Medicaid route against arranging it privately, or need coverage sooner than an approval cycle allows, call (718) 232-2777 or reach us through our contact page. Licensed by the New York State Department of Health, licence #2572L001.
Frequently asked questions
What is private duty nursing?
Continuous, one-on-one nursing care from an RN or LPN focused on a single patient, for people whose nursing needs go beyond what a Certified Home Health Agency’s part-time or intermittent visits can cover.
Who can provide private duty nursing in New York?
A licensed home care services agency enrolled as a Medicaid provider, or a privately practicing RN or LPN who is individually Medicaid-enrolled. LPNs must practice in compliance with Article 139 of the New York Education Law, generally under physician oversight.
How do I get Medicaid to approve private duty nursing?
A physician or nurse practitioner writes an order describing medical necessity, frequency, whether RN or LPN care is needed, and recommended hours. The request then goes through prior approval with the state or local Medicaid district, generally decided within 21 days if fully documented.
How long does a private duty nursing approval last?
Approvals are typically issued for up to six months at a time, with recertification required to continue beyond that period.
Can I get private duty nursing without Medicaid?
Yes. Private duty nursing can be arranged directly through a licensed home care agency on a private-pay basis, without going through Medicaid’s prior-approval process.
What’s the difference between private duty nursing and CDPAP?
CDPAP lets a consumer hire and train their own personal assistant, who doesn’t need nursing credentials. Private duty nursing is delivered by a licensed RN or LPN performing skilled nursing tasks the assistant isn’t licensed to do.
Medicaid policy details can change; the process above reflects New York State Department of Health guidance checked on 27 September 2026. Confirm current requirements with the Medicaid Helpline (1-800-541-2831) or your local social services district.
