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If your child relies on a trach, ventilator, feeding tube, or needs skilled care around the clock, you don’t have to do it alone. Private duty nursing (PDN) brings a licensed nurse into your home for scheduled shifts, so your child gets hospital-level care and you get to be a parent again. In Texas, Medicaid covers PDN for eligible children. This guide explains who qualifies, what’s covered, and exactly how to get started.

What is private duty nursing?

Private duty nursing is one-on-one skilled nursing care in your home, provided by a registered nurse (RN) or licensed vocational nurse (LVN). Unlike a short home health visit, a PDN nurse stays for a full shift, often 8 to 12 hours, and focuses only on your child.

A PDN nurse may:

• Manage tracheostomy care, suctioning, and ventilator settings
• Give G-tube or J-tube feedings and medications
• Monitor oxygen, seizures, and vital signs
• Spot early warning signs and call the doctor before a small problem becomes an ER visit
• Teach parents and caregivers so the whole family feels confident

Who qualifies for private duty nursing in Texas?

Texas Medicaid covers PDN for children and young adults under 21 through Texas Health Steps–Comprehensive Care Program (THSteps-CCP), including children in STAR Kids and STAR Health. To qualify, your child generally needs:

1. Active Texas Medicaid (including STAR Kids, STAR, or STAR Health).
2. A doctor’s order for skilled nursing at home. (Agencies like CHH will obtain this for you, but your doctor has to sign for it.)
3. Medical necessity: your child needs ongoing, skilled nursing observation and care. This often means depending on medical technology (like a ventilator or trach) or needing frequent skilled care where a delay could cause serious harm.

Not sure if your child qualifies? That’s what our free intake call is for. We’ll walk through your child’s needs and tell you honestly whether PDN is the right fit.

How to get started: 5 steps

1. Call us for a free intake. We’ll ask about your child’s diagnosis, equipment, and insurance.
2. We contact your child’s doctor. We request the orders and plan of care Medicaid needs.
3. An RN visits your home. Our nurse completes an in-home assessment of your child’s care needs.
4. We submit for approval. We send the request to your child’s health plan or TMHP. Initial approvals are often shorter; once care is stable, Texas can approve up to 180 days at a time.
5. We match your nurse and start care. We schedule nurses trained in your child’s specific needs and introduce them before the first shift.

We handle the paperwork. You focus on your child.

What it costs

For children with Texas Medicaid, approved PDN hours are covered at no cost to the family. If your child has private insurance only, we’ll check your benefits with you. Many children with complex medical needs also qualify for Medicaid through a waiver program, even if parents’ income is above Medicaid limits.

Why families choose Children’s Home Healthcare

• Pediatric only. Our nurses care for children, from NICU graduates to teens.
• Trained and competent. Every nurse completes hands-on pediatric training before their first shift.
• Consistent nurses. We work to keep the same small team with your child, so trust builds.
• Local support. A clinical manager you can reach, not a call center.

Frequently asked questions

How many nursing hours will my child get? Hours are based on your child’s medical needs, the RN assessment, and your doctor’s orders. Your health plan makes the final decision. We’ll help you request the hours your child truly needs.

Can I choose my child’s nurse? Yes, you’ll meet your nurses, and if one isn’t the right fit, we’ll make a change.

Can a parent be paid as the nurse? No. Texas Medicaid does not pay PDN claims submitted by a parent or guardian of a minor child.

What if my child turns 21? THSteps-CCP ends at 21. We start planning with your family well before then so care continues through adult programs.

Do you serve my area? We serve families across Texas and New Mecixo. Call us to confirm coverage for your city.

Ready to talk? Call 888.261.5352 or request a free intake call today. A nurse will call you back within one business day.