Utah Physical Disabilities Waiver Family Caregiver Pay Rules (2026)

Families caring for an adult relative with a serious physical disability in Utah can be paid through a Medicaid program that funds personal assistance at home.1 The Utah Physical Disabilities Waiver family caregiver rules let relatives, including a spouse, parent, step-parent or guardian, be the paid attendant for an adult with a physical disability who selects, trains and supervises their own attendants at home.1,2 To start, apply for services with the Division of Services for People with Disabilities (DSPD) at 1-844-275-3773.3

In This Guide

• Who the Utah Physical Disabilities Waiver Pays as a Family Caregiver
• Can a Spouse or Parent Be Paid?
• Who Qualifies for the Utah Physical Disabilities Waiver
• How Utah Physical Disabilities Waiver Family Caregiver Pay Works
• How to Start in Utah

Who the Utah Physical Disabilities Waiver Pays as a Family Caregiver

Utah's federal application for the Physical Disabilities Waiver, in the 2022 edition we can cite, allows payments to relatives qualified to provide the service and, apart from the participant's parents, step-parents and legal guardians, places no restrictions on paying relatives.1

These Utah Physical Disabilities Waiver relative-pay rules come from its 2022 waiver application (UT.0331.R05.04). CMS lists a renewal (0331.R06.00), effective July 1, 2026, as the current edition, and we could not confirm its relative-pay terms from a copy we can cite, so today's rules may differ and the conditions below may not be the complete list. DSPD's 2026 rules below are the current ones we can confirm; ask DSPD about the rest.1

Can a Spouse or Parent Be Paid?

Yes, with conditions. DSPD's current self-administered services rules for the Utah Physical Disabilities Waiver let a spouse, parent, step-parent or guardian be your relative's paid employee when hiring them is in your relative's best interest, it is your relative's own choice backed by their person-centered support team, and caregiver capacity and burnout have been evaluated as not limiting the care. Their pay can't be billed for more than 40 hours a week.2

The waiver's 2022 text sets more conditions. It lets a spouse, parent or guardian be paid only for extraordinary care: care beyond the daily-living and household help a spouse or parent would ordinarily give someone the same age without a disability or chronic illness, needed for your relative's health and welfare and to avoid institutional care. For a spouse, that text lists three more conditions, on top of the primary-caregiver, best-interest and signed service agreement rules below:1

• your spouse chose you, and the care team supports it;
• you provide no more than 40 hours a week of the approved service; and
• you have a unique ability to meet their needs, such as special skills or training like nursing licensure.1

Don't assume a paid parent or guardian is exempt from these three; ask DSPD how they apply to you.

That text limits this pay to parents, guardians and family members who are your relative's primary caregivers; otherwise, Utah expects respite and other waiver supports to be explored.1 It also requires your relative's person-centered support plan to document that best-interest criteria are met, including a service agreement the spouse, parent or guardian signs to carry out the plan under federal and state law, and Utah's review weighs the caregiver's own well-being.1 Because a newer edition took effect July 1, 2026, ask DSPD whether any of these conditions have changed.

For a parent, step-parent or guardian, the waiver's text allows pay only when at least one of four situations applies: your relative lives in a rural area within five miles of a community of fewer than 2,500 people, has no other help available within 15 miles, and keeps recruiting helpers other than you; you have specialized training to run health-related technology, such as a ventilator, feeding tube, home dialysis or wound care, and your relative has no other dependable or qualified help for it; your relative is functionally quadriplegic and depends on others for health, safety and daily care; or your relative needs support critical to their health and safety outside normal work hours, such as at night.1 DSPD's physical disabilities caregiver compensation guidance also requires, among other conditions, that the service be in the person-centered support plan, that a paid parent, step-parent or guardian not be paid more than an employee would be, and that timesheets be submitted.5

Who Qualifies for the Utah Physical Disabilities Waiver

Utah Medicaid's Physical Disabilities Waiver page says your relative must:1

• be 18 or older, with a physician certifying the physical disability;
• have a physical impairment causing functional loss of 2 or more limbs, and need at least 14 hours a week of personal assistance;
• be able to select, supervise and train their attendant, and manage their own financial and legal matters;
• need a nursing facility level of care and meet Medicaid financial eligibility; and
• have at least one trained (or willing to be trained) attendant available, in a home that is safe and adequately equipped for their care.1

Utah's Physical Disabilities Waiver serves a limited number of people, has a waiting list, and covers only the services your relative is assessed as needing.1 A waiting list can mean a long stretch of unpaid care, so apply early and keep notes on the care you give.

Caring for an aging parent? DSPD can't serve people whose main need for help comes from conditions due to aging, or from deteriorating diseases such as Alzheimer's disease and dementia.3 See the Utah Aging Waiver and our Aging Waiver guide instead.

How Utah Physical Disabilities Waiver Family Caregiver Pay Works

The Physical Disabilities Waiver is built on self-direction: your relative must be able to select, train and supervise their own attendant.1 Its 2022 waiver application notes that Utah's regular Medicaid personal care benefit doesn't offer that option.1

Across the waivers DSPD manages, its caregiver compensation introduction says pay for a spouse, parent, step-parent or guardian caregiver is available through both a provider model and the self-administered model.5 The Physical Disabilities Waiver itself requires your relative to self-direct their Personal Attendant Services, so ask DSPD which model is open to your relative.1

In DSPD's 2026 self-administered billing codes, personal assistance from a spouse is PA2 and from a parent, step-parent or guardian is PA3 when your relative gets Physical Disabilities Waiver services; any other employee is PA1. PA2 and PA3 can't be billed for more than 40 hours a week, and personal assistance can't be billed at the same time as other DSPD services. These are billing codes, not pay rates.2

We found no published Utah Physical Disabilities Waiver pay rate for family attendants; the typical pay above is an occupation wage estimate.4 Without a published rate, ask DSPD what the attendant would earn before anyone cuts work hours.

How to Start in Utah

Learn More

Find personalized help getting paid through Utah's Physical Disabilities Waiver at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.