Summary of Price Certification Form for In Home Services

This is a Price Certification Form for In Home Services submitted to the Montgomery County Office of Aging Services in Pennsylvania. The form establishes reimbursement rates for personal care services provided through the OPTIONS program for fiscal year 2026/2027. The services covered include personal care assistance at $27 per hour (unit basis) under an agency model, and personal emergency response systems at $30 per month, which are inclusive of fall detection sensors, cell or land line service, installation, and maintenance. Providers submitting this form must include a copy of their current license as supporting documentation. The stated rates will serve as the basis for determining actual provider reimbursement amounts, subject to applicable service codes.

The form requires signature authorization from a representative of the provider organization along with the representative's title and submission date. The form was last revised in January 2026. These certified rates represent the standard reimbursement structure that Montgomery County will use to compensate providers delivering in-home personal care services to older adults enrolled in the OPTIONS program. The pricing structure establishes a predictable, standardized approach to provider compensation for services delivered directly in the homes of Montgomery County residents requiring assistance with activities of daily living.