Since July 3, 2026 a personal care attendant may work no more than 60 hours in a single week, down from 66. The limit is on the attendant, not on you. Your approved hours did not change, but if one PCA was covering most of them, the schedule may no longer be legal.

There is a second number that matters more. Above 50 hours a week for one consumer, your PCA needs an overtime prior authorization before working the hours, not after.

Is the 60 hours per PCA or per consumer?

Per PCA, in the aggregate. That last phrase is the part people miss. If your attendant also works for somebody else, every hour counts toward the same 60. Two consumers each scheduling 35 hours puts that attendant at 70, which is over the cap, and neither consumer may know it is happening.

So ask the question directly before you build a schedule: do you work for anyone else, and how many hours. You are the employer, and this is the kind of thing an employer is expected to know.

When do I need an overtime prior authorization?

Any time one PCA will work more than 50 hours in a week for you. Between 50 and 60 hours the authorization is required, and above 60 nothing can authorize it. If your attendant works for more than one consumer, each consumer needs their own authorization.

You request it, not the attendant. You have to give a specific reason and back it up, and the approval is temporary, running anywhere from one to twelve weeks.

What reasons actually get approved?

• Your attendant's hours across multiple consumers add up past the limit.
• You have genuinely not been able to hire another PCA. Document the attempts.
• Planned travel inside the United States or its territories. You will need the dates.
• One of your other PCAs is out on short term leave.
• A temporary clinical need, including hospice.

There are also continuity of care authorizations for certain ongoing medical needs, which is the route to look at if this is not a short term gap but the shape of your life.

What happens if we just go over?

Scheduling overtime without an authorization is a violation of the program regulations, and after a third violation both the consumer and the PCA can be suspended or terminated from the program. The attendant usually still gets paid for hours worked, so the penalty is not financial, it is your eligibility.

That is a harsh outcome for a scheduling mistake, which is exactly why it is worth understanding the counting before it becomes a pattern.

My PCA quit and nobody else is available. Now what?

This is the situation the cap creates and it is the honest problem with the rule. If you have approved hours and no one to work them, the hours do not help you. Three things to do in order.

• File the overtime request anyway with the hiring difficulty documented, so the gap is on the record rather than invisible.
• Split the week across two attendants even if one is only doing a few hours. A second PCA on the roster is insurance against the week your main one is sick.
• Cover the gap with paid hours if you can, and keep the authorized hours for the attendant you have. Our home health aide care is $45 an hour from one to eight hours a day, with no minimum contract and no assessment fee, which means you can buy a Tuesday morning without buying a schedule.

Does the cap apply to live in attendants?

Live in arrangements have their own treatment under the program, including a separate exemption from electronic visit verification that has to be recertified each year. If your attendant lives with you, confirm with your fiscal intermediary how your weeks are being counted rather than assuming the standard rule applies, because the answer changes what you can schedule.

Who can help us fix the schedule?

Your personal care management agency. That is what a PCM is for. We handle the intake and orientation, the nurse and occupational therapist evaluation, the prior authorization paperwork and the skills training, and the overtime request is part of that work. Your fiscal intermediary runs payroll and the timesheets, which is a separate job from this one.

Care Remedy is a PCM agency serving eastern and central Massachusetts from offices in Woburn, Brockton and Springfield. If you are enrolled with another PCM and the overtime paperwork is not getting done, you can transfer. Call 781-957-8076 or email pcm@careremedy.com.

Program rules change. Confirm current limits with MassHealth or your PCM agency before you set a schedule.