IDD Medicaid rates in Mississippi sit below the national median on most hourly services, but Mississippi's IDD wages sit far below the national median too. Mississippi pays $5.04 per 15 minutes for in-home supports on code S5135, or $20.16 an hour, effective 2026-01-01. That ranks 23rd of 29 states and is 42.3% below the national median of $34.92.
The median Mississippi direct support professional earns $15.00 an hour, against $22.08 nationally. That gap explains how Mississippi providers operate at rates that would lose money elsewhere, and it is the starting point for reading every rate on this page.
| Service | Code | Mississippi per hour or day | Rank | vs national median |
|---|---|---|---|---|
| Prevocational services | T2047 | $26.92 / hour | 8 of 28 | +44.2% |
| Day habilitation | S5100 | $21.04 / hour | 19 of 32 | -9.1% |
| In-home supports | S5135 | $20.16 / hour | 23 of 29 | -42.3% |
| Supported employment | H2025 | $27.12 / hour | 29 of 39 | -33.6% |
| Residential habilitation | S5136 | $250.18 / day | 18 of 31 | -10.7% |
| ICF/IID stay | none | $474.51 | 6 of 12 | +2.1% |
Behavior support is published as a one-time amount of $526.37 on H0002, a per-evaluation payment rather than an hourly rate, so it is not ranked. Mississippi has no community integration rate in our data. All rates on this page took effect 2026-01-01, so the table reflects a single, current rate cycle.
The pattern is mixed. Prevocational services and ICF/IID care sit above the median, day habilitation and residential care sit modestly below it, and in-home and employment services sit well below it.
At $20.16 an hour, Mississippi's in-home rate is far from the top of the national range, where South Carolina pays $85.96 on T2017. It is still above the bottom three: Idaho ($15.44), West Virginia ($13.52) and Louisiana ($12.40). Mississippi bills the service on S5135, a code other states also use for companion-style in-home support.
In-home supports cover help with daily living, supervision and skill-building in a person's home. They are the service where staffing efficiency matters most, because every visit carries travel and scheduling costs that the 15-minute unit does not pay for directly.
Against the $15.00 direct support wage, the S5135 rate is close to break-even. Loaded with payroll taxes and benefits, the wage is 102.9% of the rate, a margin of -0.58 an hour of one-on-one support at the median wage. Agencies that schedule well and keep travel time down can operate near that line, but the rate leaves little room for supervision or training.
How agencies make the numbers work
When a rate sits this close to labor cost, margin comes from operations rather than from the rate. The practical levers are:
- Route density. Clustering clients geographically cuts unpaid travel between visits.
- Service mix. Pairing in-home work with services that carry better margins, such as prevocational or supported employment, spreads overhead.
- Authorization accuracy. Units delivered without a valid authorization are units that will not be paid, which at break-even rates turns into an outright loss.
- Wage positioning. Paying near the state median keeps costs in line; paying well above it requires a service mix that can fund the difference.
Prevocational services on T2047 are Mississippi's strongest hourly IDD rate. At $6.73 per 15 minutes, or $26.92 an hour, they rank 8th of 28 states and 44.2% above the $18.67 median. Minnesota ($69.42) and Oregon ($74.31) lead nationally.
Prevocational programs teach the work skills that come before a job: attendance, task completion, safety and following directions. They are often delivered in groups, which means one staff member's hour can support several people's billable units, and that is where the above-median rate goes furthest. T2047 carries 6 prior authorization rules with a daily limit, so programs need to match attendance against authorized units every day.
Day habilitation on S5100 pays $5.26 per 15 minutes, or $21.04 an hour, 9.1% below the $23.14 median and 19th of 32 states. Minnesota ($100.00) leads nationally and Indiana ($6.54) is lowest.
S5100 carries 7 prior authorization rules and a daily limit. For day programs, the daily limit sets a ceiling on revenue per person per day regardless of how long the program runs, so program hours should be designed around the authorized maximum rather than beyond it. Occupancy is the other major driver: fixed costs such as the building, vehicles and program supervisors are spread across every person who attends.
Supported employment on H2025 pays $6.78 per 15 minutes, or $27.12 an hour, 29th of 39 states and 33.6% below the $40.84 median. Because Mississippi wages are low, the loaded direct support wage takes only 76.5% of the rate, leaving $6.38 an hour. That is a thinner margin than in Missouri, which pays $77.80, but enough to deliver the service. H2025 carries 6 prior authorization rules and a monthly limit.
Job coaching includes time that is hard to bill: job development, employer outreach and travel to job sites. A monthly limit gives programs some flexibility to concentrate hours in the first weeks of a new placement, when coaching needs are highest, and taper as the person becomes independent.
Residential habilitation on S5136 pays $250.18 a day, 10.7% below the $280.27 median and 18th of 31 states. It is close to the middle of the national range, well below the District of Columbia ($567.62) and well above Illinois ($108.00) and Oklahoma ($88.66). S5136 carries 8 prior authorization rules and a yearly limit.
Mississippi's ICF/IID rate of $474.51 is 2.1% above the $464.88 median and ranks 6th of 12 states. The District of Columbia leads at $1,021.84 and Oklahoma is lowest at $174.35. ICF/IID facilities are institutional settings with nursing and active treatment requirements, so their rate funds a much broader cost base than a community group home.
For residential providers, the $14.86 median residential advisor wage, against $20.31 nationally, does more to keep group homes viable than the daily rate itself.
May 2025 federal occupational data shows Mississippi wages well below the national median for every IDD role:
- Direct support professional: $15.00 vs $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $14.86 vs $20.31
- Home health / personal care aide: $11.47 vs $17.21
- Licensed practical nurse: $24.14 vs $30.96
The low-wage, low-rate combination cuts both ways. It keeps Mississippi services viable at rates that would not work in high-wage states, but it also means competition for workers comes from retail, warehousing and other employers that pay similar wages without the training and documentation demands of IDD work.
Mississippi delivers IDD services through the HCBS Intellectual Disabilities/Developmental Disabilities (ID/DD) 1915(c) waiver and the IDD Community Support Program, a 1915(i) state plan HCBS benefit. Intellectual and developmental disability services and home and community-based services are both paid directly by the state, outside managed care.
Mississippi's managed-care program, MississippiCAN, uses risk-bearing coordinated care organizations such as TrueCare, and our IDD data counts 4 plan listings. Those plans handle medical and behavioral health benefits, where plans must pay at least the published rate, but not waiver services. See the Mississippi managed care page.
The authorization map
Authorization is a significant part of billing for Mississippi IDD services. In addition to the codes above, T2015 carries 6 prior authorization rules with a daily limit, S5125 carries 5 with a monthly limit, H2019 carries 2 with a monthly limit, and behavior support on H0002 carries 2 rules with a per-evaluation limit. Daily, monthly and yearly limits each call for a different tracking routine, so billing teams should map every code they deliver to its limit type.
Mississippi's nearest neighbors in our data are Alabama, Kentucky and Tennessee. Kentucky stands out for behavior support at $160.96 an hour, and Alabama and Tennessee each run their own waiver structures. For a provider deciding where to expand in the region, the comparison should start with the service mix: a prevocational or ICF/IID provider is better positioned in Mississippi than an in-home support agency.
Budgeting
Build budgets from Mississippi wages, not national wages. At the state median, prevocational and supported employment services carry positive margins while in-home supports sit at break-even.
Negotiating and advocating
Because these rates are set by the state, there is no plan to negotiate with. Providers influence rates through the state's public comment process when the fee schedule changes, and the most persuasive comments compare cost per hour with the published rate.
Monitoring
The Division of Medicaid publishes the Comprehensive Fee Schedule in regular editions. Check each new edition for changes to the ID/DD waiver lines, since a single edition can update every waiver rate at once.
Rates on this page are compiled from official state Medicaid publications, and each rate links to its source document, including the MS DOM ID/DD Waiver fee schedule and the DOM Comprehensive Fee Schedule, September 2026 edition. Hourly figures convert 15-minute units by multiplying by four, and national ranks compare agency-provider rates for the same service across states. Our methodology explains the conversions.
For national medians on all eight services, see the IDD rates by state hub. For every other Mississippi service line, see the Mississippi Medicaid rates page, which draws on all 30,350 current Mississippi Medicaid rates. The full dataset is described on our pricing page.