Some Rates for HCBS Approved by CMS

July 29, 2016

Note! The Rates for Skilled Nursing are Now Correct in the Revised Memo

CMS has authorized DMAS to begin using the higher rates for certain services which were approved by the General Assembly and to make those rates retroactive to July 1, 2016.  There are details in the Medicaid Memo posted last evening and available though the link on our Provider Resources page! The rates affected are as follows:
  • Personal Care, Respite Care & Companion Care (both Agency and Consumer Directed for all Waivers)
  • Skilled Nursing (ID/DD Waivers)
  • Private Duty Nursing (in the Tech Waiver) and Adult Day Health
  • In-Home Residential Support (ID/DD Waivers)
Not all of the system changes have been made to allow for the higher rates to be billed – claims already submitted for dates of service after July 1st will be reprocessed by DMAS (by August 31st) and paid at the higher rate.  The memo contains the complete list of affected services and the revised rates.  The billing codes listed are accurate for existing services, some may change when the new Waivers are approved.