WageTime runs payroll for the organizations behind consumer-directed care: agency-with-choice providers, structured family caregiving agencies, CDS program lines, and FMS organizations paying the staff they employ directly. When self-direction paychecks play by their own rules, WageTime keeps every hour on the right code.
Built for organizations running consumer-directed and self-directed care programs. WageTime is a payroll and HR platform; it is not a fiscal/employer agent and is not affiliated with, endorsed by, or sponsored by CMS or any state Medicaid program. Self-direction enrollment figure: Applied Self-Direction 2023 National Inventory.
1,520,267 people self-directed their long-term services and supports in the 2023 national inventory, up 23 percent since 2019. Every one of them steers a little payroll, and the organization behind the program answers for all of it.
Vendor fiscal/employer agent, agency with choice, bill payer: three FMS models, three different answers to who owes the 941. Get the model wrong in your payroll setup and every downstream form is wrong with it. A remarkable amount of hiring paperwork starts with a question the org chart can’t answer.
A live-in caregiver’s personal-care hours can qualify as difficulty of care payments, excluded from federal income tax under IRS Notice 2014-7. Her respite, training, and PTO hours don’t. Same person, same week, one check, and a generic payroll system that only knows taxable or not-taxable per employee gets the W-2 wrong either way.
Thirty hours with one participant, fifteen with another. Under the Labor Department’s joint-employment guidance, a third-party employer owes overtime on the combined forty-five, even though each participant’s budget only ever saw its own thirty or fifteen. The premium is real, and it lands between two spending plans.
Self-direction is full of family caregivers, and household-employment rules treat each relationship differently: wages to a spouse, a child under 21, or a parent sit outside FICA and FUTA entirely, and everyone else only crosses into FICA at $3,000 in 2026. Every worker-participant pair is its own little tax jurisdiction.
New York replaced more than 600 fiscal intermediaries with a single statewide FMS (PPL) on April 1, 2025, and the transition made the news for caregivers chasing missed paychecks. That is the whole lesson of the consolidation era: programs are won and lost at rebid time on payroll execution. A pended timesheet is a caregiver deciding to quit.
The employer changes by FMS model: vendor fiscal/employer agent makes the participant the common-law employer, while agency with choice makes the provider organization the employer of record. WageTime runs the second kind at group scale, each program entity under its own EIN.
| Company | EIN | Filings |
|---|---|---|
| Meridian Care Choices LLCAgency with choice · 212 paid | 84-2210463 | Current |
| Meridian Family Caregiving LLCFamily caregiving · 96 paid | 87-3305118 | Current |
| Meridian Program Services Inc.Corporate staff · 34 paid | 82-1147520 | Current |
Replaces the three separate payroll logins, and the intern who consolidated them in Excel.
Difficulty of care payments live or die on pay-code discipline. IRS Notice 2014-7 excludes qualifying Medicaid waiver payments from federal income tax while respite, training, and PTO stay taxable; WageTime keeps the split enforceable: one earning code per program designation, every line on one check.
Replaces the year-end spreadsheet that guessed which hours were excludable, one W-2c at a time.
Overtime counts the worker’s week, not the participant’s: when your organization is the employer, hours aggregate across every participant served, and WageTime computes the premium on the weighted-average regular rate automatically, itemized on the paystub.
| Line | Rate | Amount |
|---|---|---|
| Personal careParticipant A · 30.0 hrs | $16.50 | $495.00 |
| Personal careParticipant B · 15.0 hrs | $17.25 | $258.75 |
| Weekend differential6.0 hrs | +$1.50 | $9.00 |
Replaces the overtime premium that surfaced in a wage claim instead of a payroll run.
WageTime pays self-direction weeks from approved hours, not raw punches: clock and visit hours import from your EVV or program-management system, and anything questionable is flagged before the run instead of pending silently after it. On the demo we’ll trace the exact flow for yours.
| Worker | Hours | Status |
|---|---|---|
| Dana R.Participant C | 44.0 | Approved |
| Marisol V.Participants A + B | 45.0 | Approved |
| Kofi A.Participant D | 38.5 | Visit mismatch |
| Irene S.Participant E | 40.0 | EVV-exempt |
| Tomás B.Participant F | 12.0 | No attestation |
Replaces the Friday pend queue, and the caregiver who quit over it.
Full-service payroll is $10 a month per person paid that month, plus $50 a month per company, with unlimited runs. No long-term contracts, no per-run charges.
Off-cycle runs and bonuses cost nothing extra. No long-term contracts; cancel anytime.
Example: 50 people paid × $10 + $50 company = $550 for the month
HR & hiring, onboarding, PTO, time tracking, benefits, and workers’ comp are optional add-ons, priced separately when you’re ready.
See a demoThe FMS model decides. In the vendor fiscal/employer-agent model, the participant is the common-law employer and the FMS acts as their IRS Section 3504 agent. In agency with choice, the provider organization is the employer of record while the participant manages the day-to-day work. In a bill-payer arrangement, the FMS employs no one. Your program agreement, not your preference, decides which one you are.
Generally yes. IRS Notice 2014-7 excludes qualifying Medicaid waiver payments from federal income tax, but IRS guidance keeps them subject to FICA and FUTA unless a separate exception applies, like household-employer wages paid to a spouse, child under 21, or parent. WageTime keeps the distinction on the pay code; whether a payment qualifies belongs to your program rules and tax counsel.
Code II is where excluded Medicaid waiver payments go on the W-2, starting with the 2024 forms: qualifying difficulty of care amounts come out of box 1 and report in box 12 under code II instead. Clean reporting starts in payroll: designated hours sitting on their own earning codes all year, with the reporting itself settled with your tax counsel.
When one organization employs the caregiver, the hours add up across participants: Labor Department guidance treats 30 hours with one participant plus 15 with another as a 45-hour week owing 5 hours of overtime. WageTime aggregates the week automatically and computes the premium on the weighted-average rate across all rates worked, while job costing keeps each participant’s labor reported against their own budget.
No. WageTime does not act as a fiscal/employer agent, file Form 2678 appointments, or file aggregate Form 941 returns with Schedule R. WageTime runs payroll where your organization is the employer of record: agency-with-choice and structured family caregiving programs, CDS lines, and the FMS organization’s own staff, with each entity under its own EIN and every federal, state, and local tax filed automatically.
Federal EVV requirements under the Cures Act cover Medicaid personal care in self-direction, but CMS guidance lets states exempt live-in caregivers, and states vary. WageTime imports approved hours from your EVV or program-management system either way; tell us your system on the demo and we’ll confirm the exact flow, including how live-in-exempt weeks reach payroll. WageTime’s own mobile clock is not a substitute for state EVV requirements.
Each company pays $50 a month plus $10 per person paid that month, and a multi-entity group runs every program company under its own EIN with one login. Runs are unlimited, so weekly pay day and off-cycle checks cost nothing extra. Taxes file automatically at federal, state, and local levels, W-2s and 1099s included. No long-term contracts; cancel anytime. Onboarding and migration are full-service and paid, scoped on the demo.
Name your model (agency with choice, structured family caregiving, a CDS line), one caregiver who serves two participants, and the states you operate in. Twenty minutes with a payroll specialist on a live demo company: you’ll see the pay-code taxability split, the cross-participant overtime, the entity setup, and the invoice math.
Book a 20-minute demo