IDD Medicaid rates in New Hampshire include one of the highest behavior support rates in the country. New Hampshire pays $41.83 per 15 minutes for behavior support services on code H2019, or $167.32 an hour. That ranks 2nd of 23 ranked states and is 114.3% above the national median of $78.07, trailing only Maryland's $173.04.
The rest of New Hampshire's community IDD schedule sits much closer to the middle of the country, and its ICF/IID daily rate is among the highest published. That combination makes New Hampshire a state where clinical and facility services are paid generously while direct support hours are paid near the median.
New Hampshire's agency-provider rates for its Developmental Disabilities waiver services took effect January 1, 2024, under the BDS Rate Increase Guidance:
| Service | Code | Hourly or daily rate | Rank | vs national median |
|---|---|---|---|---|
| Behavior support | H2019 | $167.32/hour | 2 of 23 | +114.3% |
| Community integration | H2015 | $28.00/hour | 10 of 22 | +4.9% |
| Residential habilitation | T1020 | $295.72/day | 14 of 31 | +5.5% |
| Day habilitation | T2021 | $20.44/hour | 20 of 32 | -11.6% |
| Supported employment | H2023 | $29.56/hour | 26 of 39 | -27.6% |
Community integration and residential habilitation sit just above the median; day habilitation is slightly below it; supported employment is in the lower third. New Hampshire has no in-home supports or prevocational rate in our ranked data.
At $167.32 an hour, New Hampshire's behavior support rate sits 114.3% above the national median. The national ranking runs from Maryland ($173.04) and New Hampshire through Kentucky ($160.96), Alaska ($136.52) and Connecticut ($132.40) down to New Jersey ($33.20), Tennessee ($27.00) and Idaho ($24.64).
Behavior support is delivered by clinicians who write and oversee behavior plans, so the rate covers professional time rather than direct support time. A rate this high gives New Hampshire providers room to employ qualified clinicians and to fund plan development and staff training, which are hard to sustain at the lower rates found in New Jersey or Tennessee.
What the rate has to cover
A behavior support hour is rarely only face-to-face time. Clinicians observe, collect and analyze data, write and revise plans, and train the direct support staff who carry the plans out day to day. Some of that work is billable and some is not. A high hourly rate is what allows a program to absorb the unbilled portion without cutting corners on plan quality. H2019 carries 14 prior authorization rules, so clinicians' billable hours also depend on keeping authorizations current.
New Hampshire's ICF/IID daily rate is $951.10, effective July 1, 2026. The national median is $464.88 a day across 25 states. The highest published rates are the District of Columbia ($1,021.84), Maine ($995.49) and South Dakota ($926.97); the lowest are Louisiana ($232.14), Wisconsin ($201.04) and Oklahoma ($174.35). New Hampshire's figure places it alongside the top group of states on facility care.
An ICF/IID is an institutional setting with continuous active treatment, nursing and clinical staffing, so its daily rate funds a much larger cost base than a community home. The high LPN wage, at $37.07, raises costs for ICF/IID operators, which makes the high facility rate less generous than it first looks. Because this rate was updated in July 2026 while the community rates date from January 2024, it is also the most current IDD rate on New Hampshire's schedule.
Community residential habilitation is paid on T1020 at $295.72 a day, 14th of 31 and 5.5% above the national median of $280.27. The District of Columbia ($567.62), New York ($564.22) and Oregon ($503.86) are among the highest, while Iowa, Illinois and Oklahoma are lowest.
The gap between New Hampshire's ICF/IID rate and its community residential rate is large, reflecting the different intensity of the two settings. For a community residential operator, the rate is near the national middle, but New Hampshire's residential advisor wage of $23.56 sits well above the $20.31 national figure. That means the daily rate has to stretch further to cover each shift, and occupancy and staffing efficiency carry more weight here than in lower-wage states. T1020 carries 22 prior authorization rules.
Community integration on H2015
Community integration pays $7.00 per 15 minutes, or $28.00 an hour, 10th of 22 and 4.9% above the $26.70 median. H2015 carries 9 prior authorization rules.
Day habilitation on T2021
Day habilitation pays $5.11 per 15 minutes, or $20.44 an hour, 20th of 32 and 11.6% below the $23.14 median. T2021 carries 18 prior authorization rules. Day programs usually run in groups, which spreads a staff hour across several people and makes a below-median rate more workable than it is for one-to-one services.
Supported employment on H2023
Supported employment pays $7.39 per 15 minutes, or $29.56 an hour, 26th of 39 and 27.6% below the $40.84 median. H2023 carries 16 prior authorization rules. Supported employment is the service where New Hampshire trails its New England neighbors most clearly.
Federal occupational wage data for May 2025 places New Hampshire above the national median on every IDD role:
- Direct support professional: $22.57 an hour, versus $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $23.56, versus $20.31
- Home health and personal care aide: $18.64, versus $17.21
- Licensed practical nurse: $37.07, versus $30.96
Both services lose money on a one-to-one hour at the median wage. Providers make them work through group delivery, and the above-median behavior support and residential rates often carry the rest of the program.
New Hampshire's IDD codes carry a large number of prior authorization rules. T2025 has 23, T1020 residential has 22, T2021 day habilitation 18, H2023 supported employment 16, H2019 behavior support 14, H2015 community integration 9 and H2014 has 8.
Residential and day services carry the most rules, which matches where the largest dollar amounts sit. Billing teams should expect authorization to be the main administrative cost of serving people in residential and day programs. The practical safeguards are a shared authorization calendar, checks that every service line on a claim matches an active authorization, and early renewal requests for long-running services such as residential care.
In New Hampshire, intellectual and developmental disability services and home and community-based services are paid directly by the state, outside managed care. New Hampshire runs several 1915(c) waivers relevant to IDD providers, including the Developmental Disabilities waiver, the Acquired Brain Disorder waiver and the In Home Supports waiver for children with developmental disabilities.
New Hampshire Medicaid Care Management covers other services through plans including AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan; our IDD data counts 5 plan listings. For behavioral health, those plans negotiate their own rates, with the published rate applying out of network. IDD waiver providers bill the state's fee-for-service system instead. The New Hampshire managed care page shows the rule for each service line.
Two changes shaped the current rates:
- BDS Rate Increase Guidance (January 1, 2024). Published December 22, 2023, it set the rates for the community services on this page.
- State Plan Amendment NH-23-0015. A proposed Individual Service Option (ISO) service rate increase effective January 1, 2023.
The community rates have now been in place since January 2024, while the ICF/IID rate was updated in July 2026. For providers, that means the hourly services are carrying more of each year's wage growth. New Hampshire's wider Medicaid rate history in our data reaches back to 1992.
Within New England, New Hampshire leads on behavior support but trails on day and employment services. Massachusetts and Rhode Island both rank in the national top five for day habilitation, and Maine and Vermont publish their own waiver structures. For a provider deciding where to place clinical capacity in the region, New Hampshire is the strongest market for behavior support; for day programs, its neighbors pay more.
- Budget each service on its own margin. Behavior support and residential care fund the program; community integration and supported employment need group delivery or cross-subsidy.
- Plan for flat community rates. Until the next BDS rate guidance, model wage growth against rates that have not changed since January 2024.
- Track authorization as a cost. With up to 23 rules on a single code, authorization management deserves dedicated staff time.
Rates on this page are compiled from official state Medicaid publications, and each rate links to its source document, including the 2026 Fee Schedule - Covered Procedures Report with SA Requirements. Hourly figures convert 15-minute units by multiplying by four. Our methodology explains the conversions and ranking rules.
The New Hampshire Medicaid rates hub covers the full schedule, drawn from all 26,581 current New Hampshire Medicaid rates, and the national IDD rates page compares each service across states. The full dataset is described on our pricing page.