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Private duty nursing for children in Georgia

If your child needs a nurse at home for hours at a time, that is private duty nursing. In Georgia, Medicaid pays for it for children under 21 through the Georgia Pediatric Program, GAPP, and HeartPath is an approved GAPP provider.

Check eligibility Call 678-459-2590

Same care, different names

Families hear this service called a lot of things, and it slows them down. Private duty nursing is the term insurers, hospitals and other states use. Some people say shift nursing or home nursing. Georgia Medicaid calls it GAPP In-Home Nursing. They all mean the same thing: a licensed nurse who stays in your home for a scheduled shift and cares for your child the whole time.

It is different from what a hospital usually means by home health, which is a nurse or therapist who visits for an hour, does a task and leaves. Private duty nursing is for children whose care cannot wait for the next visit.

What a private duty nurse does

Trach and ventilator care, including suctioning and emergency airway management
Tube feeds, medications on schedule, and monitoring of oxygen and vital signs
Seizure monitoring and rescue medication on your physician's plan
Skilled assessment every shift, and a written note of what the nurse saw
Nights, weekends and overnight shifts, so someone else is awake while you sleep

Care is delivered by a registered nurse (RN) or licensed practical nurse (LPN), in your home. Under GAPP the hours are for your child at home: they cannot be used in a hospital, and they cannot be used at school. School nursing is arranged with the school.

Who pays for it

Georgia Medicaid, through GAPPFor children under 21 who qualify, Medicaid pays for authorized private duty nursing. There is no cost to the family for authorized hours.

Private insuranceCoverage for private duty nursing varies widely between private plans, and many cover little of it. If your child has both a private plan and Medicaid, the private plan is billed first and Medicaid is the payer of last resort.

Private payLimited private pay arrangements may be available on request. Most Georgia families pursue Medicaid first, because hourly nursing adds up quickly.

If you have been told your income is too high for Medicaid, read how Katie Beckett works. It ignores parents' income and looks only at the child's medical needs, and it is the most common way a working family gets private duty nursing paid for in Georgia.

Who qualifies

There is no list of qualifying diagnoses. Georgia Medicaid approves GAPP nursing on how much hands-on skilled care a child needs each day, documented by the child's physician. The children who most often qualify depend on a tracheostomy or ventilator, a feeding tube, oxygen, or seizure care, or have a condition such as cerebral palsy, spina bifida or hydrocephalus with daily skilled needs. What the reviewers actually look at.

Georgia Medicaid decides who is approved and how many hours a week. No agency can promise a number of hours or a timeline for the state's review.

How to start

Call us or check eligibility onlineWe tell you honestly whether your child looks like a fit, and which Medicaid door applies if Medicaid is not in place yet.
Your physician documents the needWe prepare the forms and chase the orders and the plan of treatment.
We request prior authorizationGeorgia Medicaid reviews the plan and decides the approved hours. About 30 days from first call to care starting is typical.
We match a nurse to your childFor trach, vent and other high-acuity care we match on the specific skills your child needs, and we work to keep the same nurse with your family.

Private duty nursing near you

We serve metro Atlanta and the surrounding counties and match nurses by ZIP code. Your county page has the local detail.

Questions families ask

Is private duty nursing the same as GAPP?

In Georgia, for children, yes in practice. Private duty nursing is the general name for a nurse who stays in the home for a shift. GAPP In-Home Nursing is the Georgia Medicaid program that pays for it for children under 21.

Does Georgia Medicaid cover private duty nursing for children?

Yes, through GAPP, for children under 21 whose physician documents a need for daily skilled care. Georgia Medicaid decides who is approved and how many hours.

How many hours of private duty nursing can my child get?

There is no set number. Hours are authorized per week from your child's plan of treatment, reviewed by Georgia Medicaid, and renewed with updated documentation. Be careful with anyone who quotes you hours before your case has been reviewed.

Can a private duty nurse come to school with my child?

Not on GAPP hours. GAPP hours cannot be used in a school setting. School nursing is arranged with the school, and your child's GAPP hours are scheduled around the school day.

Is overnight private duty nursing available?

Overnight shifts are a normal part of GAPP authorizations when the clinical need supports them. Whether we can staff those hours in your county is a separate question, and we will give you a straight answer on both.

What does private duty nursing cost the family?

For children approved through GAPP, nothing for authorized hours. There is no copay and no deductible.

Ready when you are.

Tell us about your child and a real person will walk you through what comes next. No cost, no obligation.

Check eligibility Call 678-459-2590

Keep reading

HeartPath Home Care is an approved provider for the Georgia Pediatric Program. We are not a government agency, and this page is not an official publication of the Georgia Department of Community Health or Georgia Medicaid. It is a plain-language guide for families. Eligibility for GAPP, Medicaid and Katie Beckett is determined solely by Georgia Medicaid and the state agencies that administer them, based on your child's documented medical needs. Program rules and figures change.