1 Medicaid Fee-For-Service Reimbursement rates , Survey results , April 2014. Directions: Please fill in the appropriate and applicable home health Reimbursement rates in the row for your state(s), indicating units as well ( $/hour, etc.). For the subsequent tabs of this spreadsheet, please fill out your state's personal care, private duty nursing, and home and community based waiver services rates as well. Feel free to add rows below the row assigned to your state(s) if necessary. Medicaid Home Health Effective State RN PT OT SLP MSW HHA Notes Date AK. LPN: $ ; Limit 104 visits per AL $ $ $ $ $ year, PT/OT/SLP for 21 and younger. AR $ $ N/A N/A $ LPN: $ $ mins (varies by AZ $ $ $ $ 10/11/13 See fee schedule for details. provider, see notes). CA $ $ $ $ $ $ 2013 LPN: $ $ 1/2. CO $ $ $ $ N/A 2013-14 after increase hour CT $ $ $ $ N/A $ 7/1/07 For other rates , see fee schedule. DC See notes. See notes. See notes.
2 See notes. See notes. See notes. See notes. No information found. Same rates in effect since 10/1/2006;. rates to left should be divided by 4. units; billing is in 1/4hr increments. DE $ $ $ $ $ $ 2013 MSW is covered only by rare exception. rates are the same for Medicaid fee for service and managed care. Florida's Medicaid program (in total). is being moved over into private HMOs. There were no standardized FL See notes. See notes. See notes. See notes. See notes. See notes. See notes. rates established by legislation, so each plan is negotiating the rates provider by provider. rates are from a sample provider, not representative of the entire state. Medicaid rates are different for each provider, based on 20 year old GA $ $ min $ min $ N/A $ 2013. Medicare cost reports with budget reductions over the years in excess of 15%. rates are currently between $45 and $110. FFS, almost all are under Managed Care.
3 For full listing, see HI N/A N/A N/A N/A N/A $ 2013. Medicaid %20 Fee% IA $ $ $ $ $ $ 7/1/13 Nonurban Urban MSA 26980-Iowa City (Johnson, IA $ $ $ $ $ $ 2013 Washington Co). For other urban rates , see fee schedule. $ $ $ $ $ (rate on file); (rate on file); (rate on file); (rate on file); (rate on file); See "current provider Reimbursement ID 7/25/12. $ $ $ $ $ rates " here. (cap limit) (cap limit) (cap limit) (cap limit); (cap limit);. IL $ $ $ $ N/A $ FY 2014. rates reflect 5% reduction of state- wide rates from 7/1/13 to 12/31/13, LPN rate is $ Overhead rate $ July to Dec IN $ $ $ N/A $ is $ Reimbursement is one min 2013. overhead per patient per provider per day. rates change July 1 of each year based on cost reports. rates reflect 3% reduction of state- wide rates from 1/1/14 to 6/30/14, LPN rate is $ Overhead rate $ Jan to Dec IN $ $ $ N/A $ is $ Reimbursement is one min 2014. overhead per patient per provider per day.
4 rates change July 1 of each year based on cost reports. Most of Kansas Medicaid is now on KS N/A N/A N/A N/A N/A N/A. KanCare (3 MCOs). KY $ $ $ $ $ $ LPN: $ $ ; $ ; $ ;. LA $ N/A $ LPN: $ $ min $ min $ min Last MA $ $ $ $ N/A $ mins updated in 2007. MD See notes. See HCBS waiver section See attachment for details ( rates in $ $ $ $ $ $ ME 2013 attachment are given in 15 min visit visit visit min visit min visit visit intervals). $ MI $ $ $ $ Jan. 2013 See fee schedule for details. visit $ $ MN $ (PT $ N/A 2013 LPN: $ (OT assistant). assistant). MN $ min $ $ $ N/A $ min 2013. $ $ MN $ (PT $ N/A 2011. (OT assistant). assistant). MN $ min $ $ N/A $ min 2011. Visit rate (1-4 hours). Therapy or MO $ N/A N/A N/A N/A $ current rate social work not offered as Medicaid Home Health benefit. No standard rates , based on cost report. MS See notes. See notes. See notes. See notes. See notes. See notes. See notes. Medicaid home health not listed in provider fee schedule.
5 All visits need prior authorization. See MT $ $ $ $ N/A $ 7/1/2013. link for details. NC $ $ $ $ N/A $ 7/1/2012 LPN: $ See provider fee schedule. Unclear if ND See notes. See notes. See notes. See notes. See notes. See notes. See notes. Medicaid home heath, and other home care rates , are included. See fee schedule for details. Nebraska DHHS plans to implement 100%. Medicaid managed care for all healthcare providers on January 1, 2017. NE $ $ $ $ N/A $ 7/1/2013. Nebraska's legislature is also considering a bill that would delay issuance of Request for Proposals to managed care organizations until September 1, 2015. Unit=15 mins. NH Medicaid has $ moved the state plan-authorized . under 2 hrs. NH $ $ $ $ N/A services to managed care on 12/1/13. $ for 2. A large proportion of NH is now on hrs.+. managed care. In New Jersey, home health services , personal care and private duty are all under Managed Care, and have been since July 2011.
6 Initially, the plans paid what the FFS program had been paying for each of these services , but since this past July when initial contracts expired for some agencies, there were cuts passed along NJ See notes. See notes. See notes. See notes. See notes. See notes. See notes. unilaterally. Other agencies'. contracts will expire in June 2014. Perhaps more concerning than the rate reductions themselves is the ratcheting back of hours, especially in the personal care assistance program. We are not privy to individual agency rates in their MCO. contracts. On January 1, 2014, New Mexico moved over to managed care/Centennial Care, with little left in Fee-For-Service . Most of the MCOs NM See notes. See notes. See notes. See notes. See notes. See notes. See notes. say they will only pay the Human services Department/Medical Assistance Division (HSD/MAD) fee schedule. $ min $ for first hour;. (Under 21); $ These rates are urban rates .
7 For details, NV $ min $ min N/A $ min 7/1/2009. $ min see fee schedule. for additional (21 and over). half hour rates vary by region. See NY Dept. of NY See notes. See notes. See notes. See notes. See notes. See notes. See notes. Health website for all rates . B=Base rate (1st hr.); U=Unit rate (ea. 15min) SFY=State Fiscal Yr. $ ; $ ; $ ; $ ; $ ; LPN: $ ; $ No more OH N/A SFY 2012. $ $ $ $ $ than 8 hrs/day (32 units combined. No more than 14 hrs (56 units). nursing/aide per week. $ OK $ $ min $ min $ 36 visits per year. LPN: $ min services are covered if dx are on the portion of the prioritized list 'above the line' funded by the legislature;. services are covered at 74% of Medicare cost recalculated biennially;. OR $ $ $ $ N/A $ 2013 supplies billed at acquisition cost limited at $50/day; SN limited to 2. visits per day with PA; all therapy limited at 1 visit per day with PA;. subject to $ copay. LPN: $ Fee-for service.)
8 PA is now 100%. PA $ $ $ N/A N/A $ 2008. Managed Care. Each licensed home care and hospice agency has a different set of Reimbursement rates within their Medicaid contract with RI EOHHS. based on RI's home health RI See notes. See notes. See notes. See notes. See notes. See notes. See notes. Reimbursement rate enhancement system.. In addition, legislation currently being considered for an increase plus COLA to Medicaid only FFS effective October 1. Medicaid HH services are cost settled based on the Medicare cost reports approx. approx. approx. approx. SC N/A so it varies; in the past, the average $122/visit $122/visit $122/visit $122/visit cost is around $112 per visit for RN, ST, OT, PT. $ RN = skilled nursing. See fee schedule SD $ $ min $ min $ 7/1/2013. min for details. TN N/A N/A N/A N/A N/A N/A TN is 100% managed care. $ SLP - $ for 0-20 min.;. TX $ $ $ $ per N/A $ 2013 $ for 21-999 min. For details visit see fee schedules.
9 UT $ $ $ $ N/A $ 7/1/2012 For details, see fee schedule. Northern VA has separate rates . Figures in chart are for the rest of the state. VA $ $ $ $ N/A $ 7/1/2009 RN= skilled nursing. RN, PT, OT, SLP rates are for initial assessments. For details see fee schedules. VT has a Medicaid home care tax that VT $ $ $ $ $ 11/1/2013 reduces the net payments by about 20%. See attachment for historic rates . $ $ SLP= speech therapy. See home health WA $ $ N/A $ 1-Oct-12. OR $ OR $ services fee schedule for other details. Requires you to report shift time;. $ - therapy assistants must be Has not skilled supervised by therapist in the home. been WI $ - $ $ $ N/A $ LPN: $ Rarely pays for updated in med HH Aide; will almost always many years management downcode to Personal Care Worker (PCW) at rates are rural. No standard rates ;. WV $ $ $ $ N/A $ CY 2014 based on cost report. For details see fee schedule. WY $ $ $ $ $ $ min Medicaid Fee-For-Service Reimbursement rates , Survey results , April 2014.
10 Directions: Please fill in the appropriate and applicable personal care Reimbursement rates in the row for your state(s), indicating units as well ( $/hour, etc.). Feel free to add rows below the row assigned to your state(s) if necessary. Personal Care Effective State Rate/Unit Notes Date rates vary by region. AK See notes. See PCS rates . See notes. AL. AR $ 2008. $ ;. $ AZ (provider type 24, 10/11/13 See fee schedule for details. see fee schedule link in notes). In Home Supportive services (IHSS): CA rates vary by county based on four levels of acuity after increase on 7/1/13. CO $ 2013-14. Also under HCBS. CT $ 7/1/13. DC $ min 11/8/13 See final rulemaking. PAS Personal Attendant, may be family, friend, guardian, person from registry, or PASA. Agency worker. Delaware DE See notes. See notes. does have a PAS (Personal Attendant Rate) and Direct Care Worker rate for personal care and homemaker. I do not have rates for those programs.