IDD Medicaid rates in Nevada are led by job coaching. Nevada pays $14.21 per 15 minutes for supported employment on code T2019 with modifier TG, or $56.84 an hour, effective April 1, 2024. That ranks 9th of 39 states and is 39.2% above the national median of $40.84 an hour.
Nevada's schedule mixes recent rates with long-standing ones. Supported employment and residential habilitation were updated in April 2024, while day habilitation and prevocational rates have been in effect since June 2018. The age of each rate matters as much as its level for a Nevada provider.
| Service | Code | Nevada rate | Rank | vs national median |
|---|---|---|---|---|
| Supported employment | T2019 | $56.84/hour | 9 of 39 | +39.2% |
| Residential habilitation | T2016 | $344.80/day | 12 of 31 | +23% |
| In-home supports | T2017 (UJ) | $4.89 per unit | not ranked | not ranked |
| Day habilitation | none | $43.45/day | not ranked | not ranked |
| Prevocational services | T2014 | $27.16/day | not ranked | not ranked |
The two ranked services both sit in the upper half nationally. The others are paid per unit or per day and are listed as published. Nevada has no community integration, behavior support or ICF/IID rate in our data.
Supported employment is the most widely published IDD service in the country, with 47 states setting a rate. Placing 9th in that field is a stronger signal than a similar rank on a service only a handful of states publish. For residential habilitation, 44 states publish a rate, and Nevada again sits in the top half. Both results suggest Nevada has concentrated its recent rate work on the services that most directly support community employment and community living.
At $56.84 an hour, Nevada sits behind New York ($141.64), Arkansas ($102.36), the District of Columbia ($97.08), Iowa ($79.82) and Missouri ($77.80), and far above the lowest states: Tennessee ($14.96), West Virginia ($12.80) and Wyoming ($12.36), all on T2019.
Nevada publishes this rate with the TG modifier, and a separate line carries TG with TN. Claims need the modifier combination that matches the service delivered to price at the published rate.
Job coaching economics
Nevada's median direct support wage, once loaded for payroll costs, is 45.1% of the T2019 rate, leaving $31.21 an hour after wages. That margin funds the travel, employer development and documentation that job coaching requires, and makes supported employment one of the more financially sustainable IDD services in Nevada.
T2019 carries a utilization limit: hours are capped within a six-month period, for both T2019 TG and T2019 TG with TN. The code carries no prior authorization rules, so the limit, not a pre-approval step, is what controls volume.
Programs need to plan coaching hours across each six-month window rather than front-loading them. In practice, a new job placement often needs intensive coaching in its first weeks, followed by fading support as the person learns the job. A program that spends most of the window's hours early can run out before the placement is stable. Good practice is to set a coaching plan for the full period at the start, track hours used each week, and adjust the fade schedule if hours are being used faster than planned.
Nevada pays $344.80 a day for residential habilitation on T2016, effective April 1, 2024. That ranks 12th of 31 states, 23% above the national median of $280.27.
The top of the range includes the District of Columbia at $567.62, New York at $564.22, Oregon at $503.86 and Alaska at $483.15. Iowa ($140.81), Illinois ($108.00) and Oklahoma ($88.66) are lowest. Nevada sits comfortably above the middle, which supports group-home staffing in a state where residential advisor wages, at $18.65 an hour, are below the $20.31 national median.
A daily rate funds every shift in the home. For operators, the levers are occupancy, the staffing pattern each resident's plan requires and overnight coverage. A rate refreshed in 2024 gives Nevada group homes a more current base than the state's day services have.
Nevada's day services are paid per day. Day habilitation pays $43.45 a day and prevocational services pay $27.16 a day on T2014, both effective since June 1, 2018. T2020 is limited to one unit per day, with a maximum of 6 hours, and carries one prior authorization rule.
A daily rate with a 6-hour maximum sets the shape of a day program: revenue is fixed per person per day whether the person attends for a short day or a full one. Programs that keep attendance consistent and design their day around the maximum get the most from the rate. Because these rates have stood since 2018, while supported employment and residential rates were refreshed in 2024, Nevada's day programs carry more of the pressure from wage growth than its employment or residential programs do.
In-home supports on T2017 with modifier UJ pay $4.89 per unit, effective July 1, 2023. T2017 and T2017 UJ combined are capped at 96 units a day, with a separate units-per-day limit for sleep time, and the code carries 2 prior authorization rules.
The UJ line and the sleep-time limit both matter for overnight support. The sleep-time limit matters for providers offering overnight support, because hours when a worker is present but asleep are counted differently from awake hours. Scheduling and timekeeping systems should separate those hours so claims match the limits.
Federal occupational wage data for May 2025:
- Direct support professional: $18.54 an hour, versus $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $18.65, versus $20.31
- Home health and personal care aide: $16.19, versus $17.21
- Licensed practical nurse: $36.62, versus $30.96
Direct care wages in Nevada are below the national median on every non-nursing role, which is what makes the supported employment and residential rates go further. The exception is nursing: Nevada's LPN wage is well above the national figure, so services that need nursing support cost more to staff here than in most states.
In Nevada, intellectual and developmental disability services are paid directly by the state, outside managed care. The Nevada HCBS Waiver for Individuals with Intellectual and Developmental Disabilities (provider type 38) is billed fee-for-service, alongside the ADSD Developmental Services regional-center provider rates for the state program.
Nevada's managed care program, the Mandatory Health Maintenance Program, uses risk MCOs, and our IDD data counts 9 plan listings, among them Anthem Blue Cross and Blue Shield Healthcare Solutions, CareSource Nevada, Molina Healthcare of Nevada and SilverSummit Health Plan. Those plans do not set IDD waiver rates, though for behavioral health they must pay at least the published rate. The Nevada managed care page lists each plan and line rule.
Nevada's IDD rates carry three distinct effective dates. Day habilitation and prevocational services date from June 1, 2018. In-home supports on T2017 UJ date from July 1, 2023. Supported employment and residential habilitation date from April 1, 2024.
That spread tells providers where rate pressure is likely to build. The longer a rate stays flat, the more of each year's wage growth the provider absorbs. A day program paying its staff today's wages on a 2018 rate faces a tighter margin than a residential program on a 2024 rate, even if both rates looked similar when they were set. When Nevada next reviews its IDD rates, the oldest lines are the ones where a provider's cost data will make the strongest case. Nevada's wider Medicaid rate history in our data reaches back to 1980.
In the Mountain region, Nevada's position is strongest on employment and residential care. Utah leads the region on prevocational services, and Idaho sits near the bottom nationally on in-home supports and behavior support. Arizona pays a high residential daily rate but sits near the bottom on day habilitation. For a provider weighing a Mountain-region expansion, Nevada offers updated rates on the two services that carry the most revenue for many agencies.
Budgeting
Budget each service on its own unit. Supported employment is hourly with a six-month cap, residential care is daily, day services are daily with a 6-hour maximum, and in-home supports are per unit with a daily cap.
Planning around rate age
Day habilitation and prevocational rates date from 2018. Programs relying on those services should model rising wages against flat rates and look for efficiencies in group size and transportation.
Billing accuracy
Most Nevada IDD pricing depends on modifiers and unit limits. Build those rules into the billing system so claims stop before they exceed a cap rather than after.
Rates on this page are compiled from official state Medicaid publications, and each rate links to its source document. 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 how unit and daily rates are compared.
The Nevada Medicaid rates hub covers the state's full schedule, drawn from all 79,042 current Nevada Medicaid rates, and IDD Medicaid rates by state compares every IDD service. The full dataset is described on our pricing page.