Advancements in Medicaid Coverage for Community Health Worker Services

November 20, 2025 - 23:41

Community health workers (CHWs), promotores, and community health representatives (CHRs) have traditionally depended on a variety of grants for their funding needs. However, a significant shift is occurring as over half of state Medicaid programs have now adopted some level of coverage and payment policy for these essential services. This notable development marks a crucial step in recognizing the vital role that CHWs, promotores, and CHRs play in the healthcare system.

To support this transition, a new toolkit has been introduced, offering model language designed for state Medicaid leaders and advocates. This resource aims to assist them in crafting State Plan Amendments and related guidance documents that will facilitate the establishment of coverage and payment for CHW, promotor, and CHR services. By providing a structured approach, the toolkit seeks to enhance the sustainability of these community-based roles, ensuring that they can continue to deliver critical health services to underserved populations. This initiative not only strengthens community health infrastructure but also promotes greater access to care for those in need.