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Public Notice: Medicaid Fee Schedule for Home and Community-Based Services Waiver for Individuals With Intellectual and Developmental Disabilities

Wednesday, December 29, 2021

The Department of Health Care Finance (DHCF), in accordance with the requirements in 29 DCMR § 1901.2, announces publication of the Medicaid Fee Schedule setting forth the reimbursement rates, effective Jan 1, 2022, for services available to participants under the Medicaid Home and Community-Based Services Waiver for Individuals with Intellectual and Developmental Disabilities (ID/DD Waiver).  
 
The Department on Disability Services (DDS), Developmental Disabilities Administration (DDA), operates the ID/DD Waiver under the supervision of DHCF.  The ID/DD Waiver was renewed by the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), for a five-year period beginning November 20, 2017, and recently amended to be effective November 1, 2020.  

As required under 29 DCMR § 1901.2, DHCF is identifying through this Public Notice the changes in the reimbursement rates for services rendered on or after January1, 2022, for certain ID/DD Waiver services listed in 29 DCMR § 1901.1. The new rates align with ID/DD Renewal Waiver Year 5 rate methodology, include the 2022 D.C. Living Wage where required, and are expressly subject to the service and other limitations described in the ID/DD Waiver and applicable rules. 

DHCF is increasing the reimbursement rates for Nineteen (19) ID/DD Waiver services as follows: 1) Assistive Technology Services, 29 DCMR § 1941; (2) Behavioral Support Services, 29 DCMR § 1919; (3) Companion Services, 29 DCMR § 1939; (4) Creative Arts Therapies Services, 29 DCMR § 1918; (5) Day Habilitation Services, 29 DCMR § 1920; (6) Employment Readiness Services, 29 DCMR § 1922; (7) Family Training Services, 29 DCMR § 1924; (8) Host Home without Transportation Services, 29 DCMR § 1915; (9) Individualized Day Supports Services, 29 DCMR § 1925; (10) In-Home Supports Services, 29 DCMR § 1916; (11) Occupational Therapy Services, 29 DCMR § 1926; (12) Physical Therapy Services, 29 DCMR § 1928; (13) Residential Habilitation Services, 29 DCMR § 1929; (14) Respite Services, 29 DCMR § 1930; (15) Speech, Hearing and Language Services, 29 DCMR § 1932; (16) Supported Employment Services – Individual and Small Group Services, 29 DCMR § 1933; (17) Supported Living Services, 29 DCMR § 1934; (18) Parenting Support Services, 29 DCMR § 1942; and (19) Wellness Services, 29 DCMR § 1936.  

For Personal Care Services, 29 DCMR § 1910 and Skilled Nursing Services 29 DCMR § 1931, DHCF will reimburse providers at the rate set forth in the Medicaid Fee Schedule for the Medicaid State Plan, and for Dental Services, 29 DCMR § 1921, DHCF will continue to reimburse providers at the rate set forth in the Medicaid Fee Schedule for the Medicaid State Plan increased by twenty (20) percent.  

These reimbursement rates for each service will be included on the Medicaid Fee Schedule for the ID/DD Waiver and will become effective January 1, 2022. These new rates do not replace the rates established in response to the Public Health Emergency. The Medicaid Fee Schedule for the ID/DD Waiver is located on the DHCF website at https://www.dc-medicaid.com/dcwebportal/nonsecure/feeScheduleDownload.  For further information or questions regarding this fee schedule update, please contact Samuel Woldeghiorgis, Associate Director, Office of Rates, Reimbursement, and Financial Analysis, DHCF, at [email protected] or via telephone at (202) 442 9240.