IDD services Medicaid rates by code
20 IDD services codes with published Medicaid rates in five or more states. Each page compares every state's rate, unit and managed-care rule.
- Codes
- 20
- In 40+ states
- 0
All IDD services codes
| Code | Service | States | Median rate |
|---|---|---|---|
| G0403 | Consultative clinical assessment (IDD) | 8 | $12.88 |
| H0043 | Supported housing, per diem | 18 | $48.39 |
| H0045 | Respite care services, not in the home, per diem | 23 | $180.00 |
| H2023 | Supported employment, per 15 minutes | 26 | $17.54 |
| H2024 | Supported employment, per diem | 6 | $50.45 |
| H2025 | Ongoing support to maintain employment, per 15 minutes | 19 | $13.91 |
| S5105 | Day care services, center-based | 11 | $63.06 |
| T1023 | Screening to determine the appropriateness of consideration... | 38 | $56.37 |
| T2013 | Habilitation, educational, waiver; per hour | 11 | $24.94 |
| T2014 | Habilitation, prevocational, waiver; per diem | 6 | $161.68 |
| T2015 | Habilitation, prevocational, waiver; per hour | 20 | $13.93 |
| T2016 | Habilitation, residential, waiver; per diem | 23 | $239.09 |
| T2017 | Habilitation, residential, waiver; 15 minutes | 19 | $9.77 |
| T2019 | Habilitation, supported employment, waiver; per 15 minutes | 28 | $9.23 |
| T2020 | Day habilitation, waiver; per diem | 13 | $91.89 |
| T2021 | Day habilitation, waiver; per 15 minutes | 29 | $6.44 |
| T2024 | Service assessment/plan of care development, waiver | 23 | $103.65 |
| T2032 | Residential care, not otherwise specified (nos), waiver | 5 | $2,865.14 |
| T2033 | Residential care, not otherwise specified (nos), waiver | 24 | $208.24 |
| T2034 | Crisis intervention, waiver; per diem | 9 | $490.25 |
What the IDD services line covers
The IDD services line groups the codes billed mostly by providers of waiver services for people with intellectual and developmental disabilities. Across the 51 state programs we cover, 20 codes in this line have a published fee-for-service rate in five or more states. By code set, the line is made up of 13 HCPCS Level II state Medicaid agency codes, 5 HCPCS Level II behavioral health codes, 1 HCPCS Level II professional services code and 1 HCPCS Level II temporary national code.
How to read the index
- Code opens the code's page: every state's rate ranked, the unit, a per-hour figure for timed codes, the managed-care rule and a Medicare comparison where the units match.
- States is the number of state Medicaid programs that publish a fee-for-service rate for the code. A higher count makes the median more representative.
- Median rate is the middle published amount across those states, in the units they use. When states publish a code in different units, the median mixes them, so open the code before relying on it.
Why IDD services rates differ between states
- Waiver rates are usually built from a rate model with assumptions about wages, benefits, training and productive time, and states rebuild those models on different schedules.
- Rates vary with staffing ratio, setting and the person's assessed level of support.
- Each waiver can carry its own fee schedule, so one state may publish several rates for the same service.
Billing and units
Day services and supported employment are commonly billed in 15-minute units or per day; residential services per day or per month. Modifiers often identify the staffing ratio or support tier, and each carries its own rate.
Frequently asked questions
How many IDD services codes have Medicaid rates here?
20 codes with a published fee-for-service rate in at least five state Medicaid programs. The typical code in this line is published by 19 states.
Which IDD services codes are published by the most states?
T1023 (38 states), T2021 (29 states), T2019 (28 states), H2023 (26 states) and T2033 (24 states).
Can I compare the median rates in this list?
Only with care. Each median is taken across the states that publish the code, in the units they publish it in. Open a code to see the unit each state uses and whether the code is ranked like-for-like.
How are IDD services services billed?
Day services and supported employment are commonly billed in 15-minute units or per day; residential services per day or per month. Modifiers often identify the staffing ratio or support tier, and each carries its own rate.
Where do these rates come from?
From each state's official Medicaid fee schedules, rate notices and provider bulletins. Every rate on a code page links to its source document and effective date.