If your child has complex medical needs, finding the right care can feel like a full-time job. PPEC centers — also called medical daycares — give children expert nursing care, therapy, and a chance to just be kids. All in one place, and fully covered by Medicaid.
But here's the hard truth: not every state has a PPEC program. Only 13 states currently offer licensed PPEC or equivalent medical daycare services. That means 74% of families with medically complex children have no access to this type of care in their state.
This guide breaks down exactly which states have PPEC programs, what they're called in each state, and how to find a center near you. If you're in Florida or Texas, we'll also show you how Spark Pediatrics can help your family get started today.
Not sure what a PPEC is? Read our complete guide to PPEC centers first.
What Is a PPEC?
PPEC stands for Prescribed Pediatric Extended Care. It's a licensed, non-residential medical daycare for children from birth through age 20 who have complex medical needs.
Think of it as the best of both worlds: your child gets hospital-level nursing care during the day while also playing, learning, and making friends — just like any other kid. Learn more about why families choose medical daycare.
PPEC centers typically provide:
- Skilled nursing care (trach care, G-tube management, medication administration, seizure monitoring)
- Therapy services (physical, occupational, speech, and feeding therapy)
- Developmental activities tailored to your child's abilities
- Caregiver training so you feel confident caring for your child at home
- Social interaction with other children in a safe, supervised environment
The best part? PPEC services are 100% covered by Medicaid in every state that offers them. No copays. No deductibles. No bills.
Learn more about eligibility requirements and how Medicaid covers PPEC at zero cost.
Which States Have PPEC Programs?
Currently, 13 states have licensed PPEC or equivalent medical daycare programs. Each state has its own name for the program, its own licensing rules, and its own eligibility requirements — but the core service is the same: medical daycare for children with complex needs, funded by Medicaid.
Here's a quick look at where PPEC programs exist today:
Summary Table: PPEC Programs by State
A note on the numbers: You may see sources claiming 15 or more states have PPEC programs. The count depends on what you include. Some lists count states that have regulatory language on the books but no active, licensed centers. Others include pediatric day health programs that aren't formally PPEC-licensed. The 13 states listed here all have confirmed, licensed programs with operating centers and active Medicaid coverage as of 2026. If your state passes new PPEC legislation or launches a new program, we'll update this guide.
Don't see your state? Unfortunately, 37 states currently have no licensed PPEC program. We cover alternatives for families in those states later in this guide.
State-by-State PPEC Guide
Florida — PPEC
Florida has the most developed PPEC network in the country. With dozens of licensed centers across the state, Florida families have more access to medical daycare than anywhere else in the US.
Program details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: Birth through age 20
- Hours: Up to 12 hours per day
- Cost: 100% covered by Florida Medicaid — zero out-of-pocket
- Licensing: Regulated by the Agency for Health Care Administration (AHCA)
- Children served: Over 3,600 children receive PPEC services through Florida Medicaid
Eligibility in Florida:
Your child may qualify for PPEC in Florida if they:
- Are enrolled in Florida Medicaid
- Are under 21 years of age
- Have a medically complex or technology-dependent condition
- Require skilled nursing care or ongoing medical interventions
- Have a physician's prescription for PPEC services
Official resources:
- AHCA PPEC Program Page (program overview, provider enrollment, policy)
- Florida Medicaid Provider Enrollment (verify a center's active enrollment status)
How to find a PPEC in Florida:
Florida's PPEC centers are concentrated in major metro areas including Miami, Orlando, Tampa, Jacksonville, and West Palm Beach. Many areas have multiple providers to choose from.
Spark Pediatrics is Florida's largest PPEC provider with 12 centers across the state. Our locations include centers in Miami, Hialeah, Hollywood, Fort Lauderdale, West Palm Beach, Orlando, Tampa, and more.
Every Spark center is staffed with NICU- and PICU-experienced nurses, maintains a 1:3 staff-to-child ratio, and offers integrated therapy services on-site. Families we serve see up to 60% fewer hospital visits compared to home care alone.
Ready to get started in Florida? Check if your child qualifies or find a Spark location near you.
Texas — PPECC
Texas calls its program PPECC — Prescribed Pediatric Extended Care Center. The service is the same as PPEC in other states: skilled nursing, therapy, and developmental care in a medical daycare setting, fully covered by Medicaid.
Program details:
- Name: Prescribed Pediatric Extended Care Center (PPECC)
- Ages: Birth through age 20
- Hours: Up to 12 hours per day (between 5 AM and 9 PM)
- Annual limit: 400 hours per year through Texas Medicaid
- Cost: 100% covered by Texas Medicaid (including STAR Kids managed care)
- Licensing: Regulated by the Texas Health and Human Services Commission (HHSC)
Eligibility in Texas:
Your child may qualify for PPECC services in Texas if they:
- Are enrolled in Texas Medicaid (including STAR Kids)
- Are under 21 years of age
- Have complex medical conditions requiring skilled nursing
- Have a detailed physician order for PPECC services
- Receive prior authorization from Medicaid or their managed care organization
- Have a completed plan of care signed by the ordering physician, the PPECC RN, and the responsible adult
Recent changes in Texas (December 2024):
Texas updated PPECC benefit criteria effective December 1, 2024. If you applied before and were denied, it may be worth checking the new guidelines with your provider.
Official resources:
- Texas HHS PPECC Page (program overview, policy, and provider letters)
- Texas Online Provider Lookup (TMHP) (find enrolled PPECC providers by city or county)
- PPECC Provider Resources (information letters, enrollment forms)
How to find a PPECC in Texas:
The PPECC network in Texas is growing, with centers in major metro areas including Houston, Dallas-Fort Worth, San Antonio, and Austin.
Spark Pediatrics recently expanded to Texas with our Houston center. We brought the same care model that's served thousands of Florida families — experienced nurses, integrated therapy, and a warm environment where your child can thrive.
Looking for medical daycare in Texas? Visit our Houston location page or get started today.
Alabama — PPEC
Alabama has a small but active PPEC program under Medicaid. Licensed PPEC centers serve children with complex medical needs from birth through age 20.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Medicaid covered: Yes
Official resources:
- Alabama Medicaid Agency (main site, program information)
- Alabama Medicaid Provider Search (find enrolled providers by service type)
The number of PPEC centers in Alabama is limited compared to states like Florida. Families in border areas near Georgia or Florida may also be able to access PPEC centers in neighboring states through Medicaid reciprocity agreements.
Georgia — PPEC
Georgia licenses PPEC centers under its Medicaid program. The program serves children from birth through age 20 with medically complex conditions.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Medicaid covered: Yes
- Cross-border access: Georgia PPEC centers that regularly serve Florida Medicaid recipients can enroll as in-state Florida Medicaid providers — and vice versa. This is helpful for families near the FL/GA border.
Official resources:
- Georgia Medicaid Find a Provider (search for PPEC providers by location)
- Georgia DCH Provider Manual (coverage details and requirements)
Illinois — PPEC
Illinois offers Prescribed Pediatric Extended Care as a Medicaid benefit for children with complex medical needs.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Medicaid covered: Yes
- Ages: Birth through age 20
- Availability: Limited number of licensed centers, primarily in the Chicago metro area
Official resources:
- Illinois HFS Provider Directory (find and verify licensed PPEC providers)
- Almost Home Kids (established Illinois PPEC provider)
Kentucky — PPEC
Kentucky's PPEC program is fully funded by KY Medicaid with no cost to families — regardless of household income. If your child qualifies based on medical need, services are covered.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: 6 weeks through 21st birthday
- Medicaid covered: Yes — 100%, no income requirement
- Regulatory authority: Licensed under KRS 216.890
- Services included: Skilled nursing, PT, OT, speech therapy, feeding therapy, child life specialist, dietary program
Official resources:
- Kentucky CHFS Provider Directory (search for Medicaid-enrolled PPEC providers)
- 902 KAR 20:280 PPEC Regulation (full licensing requirements)
- The Kidz Club (Kentucky's first PPEC, established 1996, locations in Louisville)
- Easterseals Redwood PPEC (Northern Kentucky: Florence, Ft. Mitchell, Newport)
Louisiana — PPEC
Louisiana has an established PPEC program through its Medicaid system. Children must have an active Medicaid number to receive services.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: Birth through age 20
- Medicaid covered: Yes
- Requirements: Active Louisiana Medicaid enrollment, physician referral, and medical necessity determination
Official resources:
- LDH Pediatric Day Health Care Facility Page (program overview and licensing info)
- Louisiana Medicaid Provider Finder (search for PDHC/PPEC providers by location)
- Medicaid Specialty Care Help Desk: 1-888-758-2220
Minnesota — PPEC
Minnesota authorizes PPEC centers under state statute (Chapter 144H), making it one of the states with a formal legislative framework for the program.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: Birth through age 20
- Medicaid covered: Yes
- Regulatory authority: Minnesota Department of Health under MN Statutes Chapter 144H.01–144H.20
Official resources:
- MDH PPEC Center Licensure Page (forms, requirements, licensed center list)
- Minnesota Statutes Chapter 144H (full regulatory framework)
Mississippi — PPEC
Mississippi added PPEC to its Medicaid State Plan in 2020, making it one of the newer state programs. The state has been actively updating reimbursement rates. [VERIFY: confirm latest rate adjustment date]
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: Birth through age 20
- Medicaid covered: Yes — covered under EPSDT (Early and Periodic Screening, Diagnosis, and Treatment)
- Prior authorization: Required through the state's Utilization Management organization
- Licensing: Centers must be licensed by the Mississippi State Department of Health (MSDH)
Official resources:
- Mississippi Division of Medicaid PPEC Page (program overview, eligibility, and policy)
- MS Medicaid Provider Search Tool (find enrolled PPEC providers)
- Division of Medicaid toll-free: 1-800-421-2408
Missouri — PPEC
Missouri's PPEC program operates through MO HealthNet (the state Medicaid program) but currently has a narrower age range than most other states.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Ages: Birth through age 6 (more limited than other states)
- Medicaid covered: Yes — through Healthy Children and Youth Program
- Requirements: Must meet private duty nursing eligibility requirements
- Licensing: Requires both a child care license (from Dept. of Elementary and Secondary Education) and a PPEC license (from Dept. of Health and Senior Services)
- Prior authorization: Required
Official resources:
- Missouri DHSS PPEC Page (eligibility, prior authorization, provider details)
- MO HealthNet Provider Information (general provider resources)
Important note: Missouri's program is currently limited to children ages 0–6 who meet private duty nursing eligibility. The state conducted a rate study in 2025, which may signal future expansion. Check with MO HealthNet for the most current eligibility guidelines.
North Carolina — PPEC
North Carolina has a PPEC program under its Medicaid system, though the number of licensed centers is limited compared to larger programs like Florida's.
Key details:
- Name: Prescribed Pediatric Extended Care (PPEC)
- Medicaid covered: Yes
- Ages: Birth through age 20
Official resources:
- NC Medicaid Find a Doctor (search for providers by location and plan)
- NC Medicaid Provider Information (manuals, policies, enrollment)
- NC Medicaid Provider Ombudsman: 1-866-304-7062
Pennsylvania — PECC
Pennsylvania calls its program PECC (Pediatric Extended Care Center) and has been operating it since 1999 — one of the longest-running programs in the country.
Key details:
- Name: Pediatric Extended Care Center (PECC) — note the different abbreviation
- Ages: Birth through age 21
- Medicaid covered: Yes
- Licensing: Regulated by the Pennsylvania Department of Health
- History: Operating since 1999
Official resources:
- PA Dept. of Health PECC Facility Page (licensing overview and contact info)
- PA DHS Provider Directory (search for enrolled PECC providers)
- Division of Home Health contact: ra-dhhomehealth@pa.gov
South Carolina — Pediatric Medical Day Care
South Carolina delivers medical daycare through the Medically Complex Children's Waiver rather than a standalone PPEC program. This means access and age limits differ from other states.
Key details:
- Name: Pediatric Medical Day Care (through the Medically Complex Children's Waiver)
- Ages: New applicants up to age 20; currently enrolled participants can receive services through age 21 (age limit was recently increased)
- Medicaid covered: Yes, through the waiver program
- Wait list: South Carolina's Medically Complex Children's Waiver reportedly has no waitlist
Official resources:
- SCDHHS Medically Complex Children's Waiver Page (program overview, eligibility, how to apply)
- MCC Waiver Referral Form (submit a referral online)
- SCDHHS phone: 1-888-289-0709
What If My State Doesn't Have PPEC?
If you're in one of the 37 states without a licensed PPEC program, you still have options. They're not the same as PPEC — but they can help.
Private Duty Nursing (PDN): Available in most states through Medicaid. A nurse comes to your home to provide skilled care for your child. The downside: your child doesn't get the social interaction, therapy, or structured activities that PPEC provides. Learn why more families are choosing PPEC over private nursing.
Home and Community-Based Services (HCBS) Waivers: Many states offer Medicaid waivers that fund services like respite care, personal care aides, therapy, and adaptive equipment. Waiver names and benefits vary widely by state.
Katie Beckett / TEFRA Programs: These Medicaid pathways allow children with significant medical needs to qualify for coverage based on the child's condition — not the family's income. Available in most states under different names.
Early Intervention Programs: For children under 3, federally mandated early intervention services (Part C of IDEA) provide therapy and developmental support regardless of your state's PPEC status.
What you can do right now:
- Call your state Medicaid office and ask specifically about medical daycare or pediatric day health services
- Talk to your child's pediatrician about what community resources exist in your area
- Connect with parent advocacy groups — organizations like Family Voices and Parent to Parent have state chapters that know local resources
- Contact your state legislators — parent advocacy has been the driving force behind PPEC programs in every state that has one
Frequently Asked Questions
What does PPEC stand for?
PPEC stands for Prescribed Pediatric Extended Care. It's a licensed medical daycare program where children with complex medical needs receive skilled nursing, therapy, and developmental activities during the day. Some states use different names — Texas calls it PPECC, Pennsylvania calls it PECC — but the service is essentially the same.
Is PPEC covered by insurance?
PPEC is covered by Medicaid at 100% in every state that has a program. There are no copays, deductibles, or out-of-pocket costs for eligible families. Private insurance typically does not cover PPEC services, but Medicaid eligibility is based on your child's medical condition — not your family's income in many cases.
How do I know if my child qualifies for PPEC?
Your child may qualify if they are enrolled in Medicaid, under 21, and have a medically complex or technology-dependent condition that requires skilled nursing care. A physician must prescribe PPEC services, and most states require prior authorization. Read our detailed eligibility guide for more information.
How many hours per day can my child attend PPEC?
Most state programs allow children to attend up to 12 hours per day. In Texas, services are limited to between 5 AM and 9 PM, with an annual cap of 400 hours. Hours and limits vary by state — check with your local PPEC provider for specifics.
What's the difference between PPEC and regular daycare?
Regular daycare is not equipped to handle complex medical needs. PPEC centers are staffed by registered nurses and licensed therapists who provide skilled medical care — like trach suctioning, G-tube feedings, seizure monitoring, and medication management — alongside developmental activities and socialization. See our full comparison of PPEC vs. traditional daycare.
Can I use PPEC if I work full-time?
Yes. Many parents use PPEC so they can maintain employment, go to school, or care for other children. PPEC centers operate during daytime hours (up to 12 hours), giving you reliable, safe medical daycare while you handle your other responsibilities.
What if there's no PPEC in my state?
If your state doesn't have a PPEC program, look into Private Duty Nursing, Home and Community-Based Services (HCBS) waivers, and Katie Beckett / TEFRA programs through your state Medicaid office. See our section on alternatives for more details.
Does Spark Pediatrics accept new patients?
Yes. Spark Pediatrics is currently accepting new patients at all of our Florida locations and our Houston, Texas center. Check if your child qualifies or contact us to get started.
Finding the Right Care for Your Child
No parent should have to choose between their child's medical care and giving them a real childhood. PPEC centers exist to make sure they don't have to.
If you're in a state with a PPEC program, the next step is simple: talk to your child's doctor about a referral. If you're in Florida or Texas, Spark Pediatrics is here to help your family every step of the way — from checking eligibility to enrolling and walking through the door on day one.
Your child deserves expert care and a chance to thrive. Get started with Spark Pediatrics today.
This article was reviewed for accuracy as of February 2026. PPEC regulations and availability change as states update their Medicaid programs. Always verify current eligibility and provider availability with your state Medicaid office or a licensed PPEC provider.
Spark Pediatrics is Florida's largest PPEC provider and operates PPECC centers in Texas. View all locations | Learn about our services