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T2031 Medicaid reimbursement rates by state

Assisted living; waiver, per diem. 13 state Medicaid programs publish a fee-for-service rate for T2031 at the agency level. Rates run from $31.43 in Iowa to $445.29 in Utah, with a median of $103.72.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
13
Median rate
$103.72per day
Highest
$445.29Utah
Medicare (non-facility)
—not on the physician fee schedule

T2031 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$445.29⚠ over 3× mediansince 2016-07-01day—Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
FloridaAgency provider · Florida iBudget waiver for people with developmental disabilities (APD)$237.71since 2026-07-01day—Paid by the state, outside plans—Florida Medicaid Developmental Disabilit
MontanaAny qualified provider (rate does not vary by provider) · Montana Developmental Disabilities Program 0208 Comprehensive Waiver (1915(c), fee-for-service)$222.08since 2025-07-01day—Not classified—Montana Healthcare Programs Fee Schedule
WashingtonAny qualified provider (rate does not vary by provider) · Washington ALTSA residential care (adult family homes, assisted living, ARC/EARC)$181.00since 2026-01-01day—Paid by the state, outside plans—DSHS ORM All HCS Rates
IndianaAny qualified provider (rate does not vary by provider) · Indiana Money Follows the Person (TBI track)$132.06since 2023-07-01day—Paid by the state, outside plans—IHCP Professional Fee Schedule (Last Upd
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Supports for Community Living (SCL) 1915(c) waiver$105.15since 2025-01-01day—Paid by the state, outside plans—DMS Home and Community Based Services Wa
ColoradoAny qualified provider (rate does not vary by provider) · Colorado HCBS waiver for persons who are elderly, blind or disabled (EBD)$103.72since 2025-10-01day—Paid by the state, outside plans—EBD, CMHS, BI, CIH (effective October 1,
NevadaAny qualified provider (rate does not vary by provider) · Nevada HCBS Waiver for the Frail Elderly (provider types 48, 57 and 59, fee-for-service)$103.13since 2024-01-01day—Paid by the state, outside plans—Provider Type 59 Assisted Living Waiver
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$91.10since 2026-07-01day—Not classified—NJMMIS Procedure Master Listing CPTHCPCS
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Living Choices Assisted Living 1915(c) waiver$86.73since 2024-10-18day—Paid by the state, outside plans—Arkansas Medicaid Living Choices Assiste
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma ADvantage 1915(c) waiver (older adults and adults with physical disabilities)$82.64since 2024-10-01day—Paid by the state, outside plans—Reimbursement Rates for Services, ADvant
TexasAgency provider · Texas Home and Community-Based Services - Adult Mental Health (HCBS-AMH, 1915(i))$51.65since 2025-09-01day—Not classified—HHSC PFD HCBS-AMH payment rates (9-1-202
IowaAny qualified provider (rate does not vary by provider) · Iowa HCBS Elderly 1915(c) waiver$31.43since 2026-10-01day—Not classified—HCBS Habilitation and Waiver Fee Schedul

Rates marked ⚠ are more than three times the median for the same unit; they are published as shown but often reflect an office (non-facility) fee or a different scope of service. Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for T2031?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $103.72 per day. Utah pays the most ($445.29 per day) and Iowa the least ($31.43 per day).

Which state pays the highest Medicaid rate for T2031?

Utah, at $445.29 per day, effective 2016-07-01.

Do managed-care plans pay the same rate for T2031?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Other home & community services codes

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