North Dakota QSP Pay Rates for Family Caregivers

North Dakota pays family members to provide home care through the Qualified Service Provider system. If you are an adult child caring for an aging parent, you can receive state-regulated daily rates instead of providing unpaid care — but the rates, rules, and required documentation vary by program.

Current Daily Rates

North Dakota sets flat daily rates for family caregivers based on the type of care provided:

Family Personal Care (FPC): $159.54 per day. This covers hands-on ADL assistance — bathing, dressing, toileting, transfers, and mobility support. The implied hourly base is $15.95 based on a 10-hour day. Both the caregiver and the parent must share the same primary residence.

Family Home Care (FHC): $74.68 per day. This covers homemaking tasks — meal preparation, light housekeeping, laundry, medication reminders, and supervision. The implied hourly base is $7.47 based on a 10-hour day. Co-residency is also required.

SPED Personal Care: $87.76 per day for state-funded personal care delivered under the SPED program. This rate applies when the parent qualifies for SPED but not yet Medicaid.

MSP-PC (Medicaid State Plan Personal Care): $23.08 per hour (unit-rate billing). This is the highest hourly rate available and is open to family member QSPs — but spouses are strictly excluded from MSP-PC.

Spouses are eligible for FPC and FHC. Adult children, siblings, and other family members are eligible for all programs.

FLSA Overtime Rules

Under the Fair Labor Standards Act In-Home Care Final Rule, North Dakota must pay overtime to live-in family QSPs who provide more than 40 hours of authorized care per week.

Because family caregivers receive a daily rate, the overtime calculation is specific: the state derives an hourly base from the daily rate, then adds half that rate for each hour over 40.

For Family Personal Care, the overtime rate is $7.98 per additional hour. For Family Home Care, it is $3.74 per additional hour. For MSP-PC, the overtime rate is $11.54 per hour beyond the 40-hour threshold.

This matters most for Family Personal Care providers delivering seven-day-a-week care. If you are authorized for daily FPC, the weekly total exceeds 40 hours and overtime applies automatically.

The Medicaid-Compliant Caregiver Agreement

If your parent is applying for or receiving Medicaid, every dollar paid to a family caregiver without a properly documented agreement is a potential disqualifying transfer under the 60-month look-back rule. The state's penalty divisor is $442.22 per day — a $10,000 payment without documentation creates a 22-day penalty period where Medicaid will not pay for care.

A Medicaid-compliant caregiver agreement must include:

• The names of the caregiver and care recipient
• Specific services to be provided (ADL support, homemaking, supervision)
• The agreed compensation rate (matching state-regulated QSP rates)
• The schedule and hours of service
• Signatures of both parties (or the parent's legal representative)
• The date the agreement was executed — it must be signed before services begin, not retroactively

Keep copies of the signed agreement, all payment records, and service logs. The Human Service Zone will review these during the 60-month bank statement audit as part of the Medicaid application process.

How to Start Getting Paid

The pathway is straightforward but takes time:

1. Enroll as a QSP through TrainND Northeast (six to ten weeks for competency training, background check, and NPI registration)
2. Set up a Therap billing account (all electronic claims must go through Therap as of July 2026)
3. Execute a written caregiver agreement before providing any billable services
4. Coordinate with the assigned HCBS Case Manager to authorize your services within the parent's care plan
5. Bill through Therap using the correct MMIS code: S5136 for FPC, FHC-00001 for FHC, T1020 for MSP-PC or SPED personal care

The North Dakota Home Care Guide includes a pre-formatted caregiver agreement template, the complete QSP enrollment checklist, and a billing code reference sheet so you can start getting compensated for the care you are already providing.

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