TL;DR: Virginia's revised DMAS-97A/B plan of care and DMAS-99 assessment became mandatory on October 1, 2026, and DMAS says older versions now lead to denied service authorizations. The biggest change is on the DMAS-97A/B: every personal care plan has to show the time for each task, to the nearest 15 minutes, instead of a check mark on the days a task happens. That change grew out of federal pressure on how states pay family caregivers, and it turns the plan of care into an audit trail for every authorized hour. We have posted free fillable PDFs of both new forms, and at Ankota we are moving our Virginia agencies onto the new versions.
Virginia's Department of Medical Assistance Services (DMAS) issued a revised DMAS-97A/B Provider Plan of Care (Revised 8/2026) and a revised DMAS-99 Community-Based Care Member Assessment (rev. 09/26) on September 2, 2026, along with updates to the CCC Plus Waiver provider manual. Providers had to adopt both forms by October 1, 2026. The DMAS-97A/B now requires the time for each personal care task, adds a box for the type of plan (personal care, LRI personal care, or respite), expands the backup plan, and adds a section for plans where a family member is the paid caregiver. The DMAS-99 drops the Start of Care date and adds questions about physician visits, paid family caregivers, the Employer of Record, supervision and emergency response (PERS), visit frequency, and critical incidents.
If you only read one sentence of the DMAS memo announcing the changes, make it this one: use of older versions after October 1 "will result in denial of service authorization requests." That is not a paperwork nicety. A denied authorization is a stretch of care you deliver and cannot bill.
Caution
The October 1, 2026 deadline has already passed. Check every place your agency keeps a copy of these forms: the shared drive, the binder in the nurse's car, the template in your software, and any "starter packet" you hand new staff. The old version tends to survive in the place nobody thinks to look.
The new DMAS-97A/B requires time per task because Virginia now has to show that every authorized personal care hour matches real, specific work. The revised CCC Plus manual says time "must be allocated for each task on the Plan of Care," and the form itself tells the nurse or Services Facilitator to "write the amount of time for each task to the nearest 15 minutes." Respite plans still use a check mark for each task. Personal care plans, including those with a paid family caregiver, now need minutes.
The background is paid family caregivers. Virginia let parents of minors and spouses be paid as caregivers during the COVID emergency and then made it permanent. In December 2024, the federal Medicaid agency (CMS) paused approval of Virginia's waiver changes and told the state its existing procedures "have not been sufficient" to confirm that the paid care was above and beyond what a family member would normally provide. CMS approved the changes in April 2025, and the rules that followed, effective July 1, 2025, require providers to document each daily-living task and how much time it takes every day. The 2026 forms are the state catching its paperwork up to those rules.
Here is the way we explain it to agency owners. The old plan of care was a calendar: bathing happens Monday, Wednesday and Friday. The new one is a timesheet: bathing takes 30 minutes, every day, and here is the row that proves it. Once you write the time down for one kind of plan, there is no good reason to keep a second, vaguer format for the others, so the state applied it to all personal care.
The new DMAS-97A/B grid, filled in for our fictional member Luke Skywalker. Each task gets a time to the nearest 15 minutes, each section gets a daily subtotal, and the total daily time rolls up to the weekly hours on page 2.
Our original DMAS-97 just had check marks, or really Xs, on the days of the week a task was scheduled. Then we started working with a customer that serves as an independent assessor, doing the assessments and the periodic follow-ups. They asked us for a way to say how much time was allocated to each task, because that is what their work actually turns on. We built it for them, thinking it was a special case. With this revision, it is not a special case anymore. Every personal care agency in Virginia needs the version that accepts time. - Ken Accardi, Ankota
An LRI plan of care is a DMAS-97A/B for a member whose paid caregiver is a legally responsible individual, meaning a parent or legal guardian of a minor, or a spouse. Under Virginia's rules, an LRI can only be paid for activities of daily living (bathing, dressing, toileting, transferring, eating and similar tasks), and only when the care is extraordinary, meaning beyond what a family member would typically provide for someone that age. Supervision and household tasks are marked "NOT ELIGIBLE" for LRIs right on the new form, reimbursement is capped at 40 hours per week, and respite is not available when an LRI is the paid personal care provider.
The new form makes the plan type explicit with three boxes: Personal Care/Assistance, LRI Personal Care/Assistance, and Respite, with the instruction to "select only one per 97A/B." For LRI plans, the nurse supervisor or Services Facilitator also has to explain how decisions about choosing the provider were made on the member's behalf, including how involved the member was and any preferences they expressed. DMAS added an Extraordinary Care Guide (Appendix E of the CCC Plus manual) to help decide what counts as extraordinary for a given age.
This is the part of the change where our view across programs helps. We work with self-direction and FMS programs in several states, and paying family members is where every program eventually ends up having to prove its hours. Consumer-directed programs have lived with this for years: a budget, a timesheet, and someone asking whether the hours match the need. Virginia's agency-directed personal care is now picking up the same habits. If you run both agency-directed and consumer-directed services, expect your documentation for the two to start looking the same.
The revised DMAS-99 removes the Start of Care date from the header, renames "Agency Name" to "Provider Name & Phone #," and adds questions that check the member's whole support system. New items ask whether the member had a physician visit in the last 12 months (with the date and doctor), whether an aide or attendant is a legally responsible individual, who the Employer of Record is and whether they were present, whether the member needs and receives supervision or PERS, and whether they receive a medication monitor. Supervisory visits at a 30 or 60 day frequency now need a written justification of the medical need, and the critical incident question now covers the last three months.
Page 1 of a completed DMAS-99 (rev. 09/26) for Luke Skywalker. Note the new provider name and phone line, and the physician-visit question near the bottom.
The instructions were also rewritten. They are clearer about what a routine supervisory visit can skip (address, date of birth and phone can be left off if unchanged, and an unchanged functional status section can be lined through and marked "No Change"), and about what can never be skipped: health status, medication changes, hospitalizations, and the signature and date of the RN, LPN or Services Facilitator.
If your agency submits a service authorization request on an old DMAS-97A/B or DMAS-99 after October 1, 2026, DMAS says the request will be denied. In practice that means the authorization has to be redone on the new form, and any care delivered while you wait is at risk. The fix is to replace your templates now, redo any plan of care that is coming up for renewal on the new form, and make sure your nurses and Services Facilitators know that personal care plans now need minutes, not check marks.
Tip
Start with the members whose authorizations renew soonest. Put them on the new forms first, so the first plans you redo are the ones that would have been denied.
Estimate each task the way the CCC Plus manual describes it: talk it through with the member and family, apply common knowledge of how long the activity takes, and record the actual time it takes the aide or attendant to help, rounded to the nearest 15 minutes. The daily totals then roll up to the Total Weekly Hours on page 2, and those hours should line up with the member's level of care from the composite ADL score on page 1. The form shows approximate weekly hours of about 25 for Level A, 30 for Level B and 35 for Level C.
In our Luke Skywalker example, the ADL scores add up to Level of Care A, and the tasks total 23.75 hours a week. That is the check we suggest building into your review: if the weekly hours sit far above the typical range for the member's level, the plan needs a clear reason in the "Reason for change" section, because that is exactly what a reviewer will ask about. Keep personal care and respite on separate DMAS-97A/B forms, since the new form asks you to select only one plan type per form.
We covered how Virginia agencies keep personal care and respite separated, and how DMAS forms fit into billing, in our article on the top challenges for Virginia Medicaid home care agencies. Time-per-task planning also connects to what happens on the visit itself, which we wrote about in task tracking in home care software.
We have posted free fillable PDFs of both new forms, with no form to fill out to get them:
Both are the current state forms with typeable fields, so you can complete them on a computer, save them, and print them. DMAS also posts the official forms on its provider portal, and the memo above lists the full set of manual changes.
A fillable PDF is a big step up from handwriting, but it still means someone retypes the member's name, Medicaid ID, address and provider information on every form, at a desk, after the visit. In Ankota, the DMAS-97A/B and DMAS-99 are completed right in the system on a computer, phone or tablet at the point of care. The member and provider details are already filled in, the time-per-task grid totals itself, and the finished form is produced in Virginia's exact state format and kept with the rest of the client record. If you want to see how that works for your agency, take a look at our EVV software and our EVV reference guide, or contact Ankota and we will walk through your Virginia forms with you.
DMAS announced the revised forms on September 2, 2026 and required providers to adopt them no later than October 1, 2026. After that date, service authorization requests submitted on older versions are denied, so any agency still using the old forms should switch immediately.
Does every Virginia personal care plan now need time per task?Yes. The CCC Plus manual now requires the agency or Services Facilitator to document time per task on the plan of care for personal care, rounded to the nearest 15 minutes. Respite plans are the exception and still use a check mark for each task.
Who counts as a legally responsible individual (LRI) in Virginia?In Virginia's waiver rules, a legally responsible individual is a parent or legal guardian of a minor, or a spouse. An LRI can be paid for activities of daily living only when the care is extraordinary for the member's age, up to 40 hours per week, and respite is not available when an LRI is the paid personal care provider.
Can a paid family caregiver be paid for meal preparation or housekeeping?Not when the family caregiver is a legally responsible individual. The new DMAS-97A/B marks both the supervision section and the instrumental activities of daily living section (meal preparation, cleaning, laundry, shopping and similar tasks) as not eligible for LRIs. Those tasks can still appear on a regular personal care plan delivered by a non-LRI aide.
What was removed from the DMAS-99?The Start of Care date was removed from the DMAS-99 header, and "Agency Name" became "Provider Name & Phone #." The manual now defines Start of Care separately as the initial nurse or Services Facilitator assessment before any aide begins, so it no longer lives on the routine assessment form.
Do I need separate DMAS-97A/B forms for personal care and respite?Yes. The revised form asks you to select only one plan type per DMAS-97A/B: personal care, LRI personal care, or respite. A member who receives both personal care and respite needs a separate plan of care for each, which also helps keep the hours for the two services clearly apart.
Where can I download the new forms?DMAS posts the official forms on the Virginia Medicaid provider portal. Ankota also offers free fillable PDFs of the DMAS-97A/B and the DMAS-99 that you can type into, save and print, with no sign-up required.
Ankota's mission is to enable the Heroes who keep older and disabled people living at home to focus on care because we take care of the tech. If you need software for home care, EVV, I/DD Services, Self-Direction FMS, Adult Day Care centers, or Caregiver Recruiting, please Contact Ankota. And if you're ready to see how the most innovative agencies are using AI to empower their caregivers and automate the rest, meet your new companion at www.kota.care.