What it says: New rates apply to dates of service on or after December 1, 2026. Earlier dates of service are paid at the rate then in effect. Billing systems and the HCBS Waiver Fee Schedule are to reflect the changes by December 1.
Residential Habilitation (ID/RD and HASCI waivers), by level. The code is T2016 at every level; the modifier shows the level billed. Units are per day except T2017.
| Level (modifier) | Who and where | Current | New |
|---|---|---|---|
| U8 High Management | CTH II home, up to 3 people with extremely challenging behaviors | $536.86 | $552.09 |
| U7 Tier 4 (fee schedule label "forensic") | CTH II home, up to 4 people, including criminal justice involvement and severe behaviors | $536.86 | $552.09 |
| U6 Tier 3 | CTH II (up to 4) or CRCF (up to 12); includes people leaving an ICF/IID | $386.55 | $397.46 |
| U5 Tier 2 | CTH II (up to 4) or CRCF (up to 12); more support than Tier 1 | $329.61 | $338.88 |
| U4 Tier 1 | CTH II (up to 4) or CRCF (up to 12) | $278.77 | $286.58 |
| U3 SLP II | Licensed supervised living setting, typically single or double occupancy | $108.78 | $111.69 |
| U2 CTH Tier 2 | Provider's own CTH I home, up to 3 people; supports beyond CTH Tier 1 | $125.62 | $127.82 |
| U1 CTH Tier 1 | Provider's own CTH I home, up to 3 people | $91.76 | $93.28 |
| T2017 SLP I (per 15 minutes) | Person's own apartment or home; 24-hour phone availability | $21.49 | $22.06 |
CTH = Community Training Home; SLP I = Supported Living Program I, SLP II = Supervised Living Program II; CRCF = Community Residential Care Facility.
Other services:
| Service | Code | Waivers (where applicable) | Current | New |
|---|---|---|---|---|
| Personal care | T1019 | CC, CS, HIV/AIDS, ID/RD, VENT; also children's state plan | $25/hr | $26/hr |
| Nursing | S9123 | HASCI, HIV/AIDS, ID/RD, VENT; also state plan | $47/hr | $48/hr |
| Enhanced nursing | T1002 | State plan | $50/hr | $51/hr |
Level definitions: OIDD ID/RD Waiver manual, Chapter 10 (rev. 03/2023), and HASCI Waiver manual (rev. Nov. 2025); the Residential Review Committee assigns the level.
Practical takeaway: Confirm your billing vendor loaded the new fee schedule and that claims spanning December 1 split by date of service.
General information, not legal advice. Requirements change; confirm against the official source before you act, or ask us how this applies to your organization.