The PCA Complex Care Rate

Starting January 1, 2026, PCAs are eligible for a $3.25 hourly wage increase if they are working for PCA Consumers (patients) who require complex care. Here is the official state website page describing the complex care wage increase.

How do my PCAs get the wage increase?

For the PCA to get the wage increase, the following qualifications must be met:

• The consumer (patient) must require either digital rectal stimulation or tube feeds (G and/or J),

• The digital rectal stimulation and/or tube feeds are DOCUMENTED TASKS on the PCA prior authorization, and

• The PCA has completed New Hire Orientation or is exempt from completing it.

How do I know if my PCA has completed New Hire Orientation and is receiving the higher hourly wage?

Log in to the timesheet portal (different from the EVV portal) here. Your username should be your PCA consumer number (choose "Consumer" for User Type). Find the PCA you're looking for and download their most recent paystub. At the top right, you should see their "NHO Status" (Incomplete/Complete). You can also see their hourly rate under the box at the top that says "Rate."

But my child only has PCA hours through Nursing Flex...

Unfortunately, your PCAs can only get the Complex Care rate differential if your child has a plain-old prior authorization JUST for PCA hours, not for nursing flex hours. If your child has both a straight PCA prior auth as well as nursing flex, then your PCAs should be able to qualify for the increased rate.

My child has nursing and PCA but still the PCAs aren't getting paid the higher rate!

By default, when a child has nursing hours, all tube feedings are put on the nursing evaluation and NOT on the PCA evalution. Therefore, it is quite likely that your child's PCA prior authorization does NOT mention tube feeds. In order for your PCAs to get the Complex Care differential rate, you'll need to do the following:

• Have your nurse manager reach out to your child's pediatrician so they can sign a form asserting that it is safe for a PCA/non-nurse to administer tube feeds

• Have your nurse manager move at least one feed from nursing to PCA. Note that this will change the number of weekly authorized hours for both nursing and PCA. You only need to move one feed to enable PCAs to be paid the higher rate.

• Ensure your PCAs have completed New Hire Orientation.

I did all this and STILL my PCAs aren't getting paid the higher rate!

Tempus can be contacted via email at MAFMS@tempusunlimited.org or by phone at (877) 479-7577. They generally respond to emails within 2 business days.