Wyoming home care Medicaid rates are above the national median for the services an aide delivers in the home and below it for respite. Wyoming Medicaid pays $8.25 per 15 minutes for personal care on T1019, or $33.00 an hour. That ranks 12th of 27 states with a comparable rate and is 8.1% above the national median of $30.52.
The timing is unusual. Wyoming's current personal care, homemaker and respite rates all took effect on July 22, 2026, rather than on the first of a month or the start of a fiscal year. Companion care was updated on July 1, 2026. For agencies, that means claims for late July 2026 can fall under two different rate sets. Every figure below is compiled from official Wyoming Medicaid publications and linked to its source document.
Wyoming's program list includes the Community Choices Waiver for elderly and physically disabled adults and the DD waivers (Comprehensive and Supports). Our managed-care data lists Wyoming Medicaid as fee-for-service for all enrollees, so the published schedule is the reference for what an agency is paid.
At $33.00, Wyoming sits in the upper half of the national ranking but well short of the leaders. Utah pays $84.84 an hour on S5125, followed by Oregon ($42.24), Iowa ($42.00), Delaware ($39.35) and Missouri ($39.00). At the bottom, Pennsylvania pays $19.48, Louisiana $19.08 and Texas $18.28.
Wyoming publishes nearly every in-home service in 15-minute units. The hourly figures in this article are four units: $8.25 a unit becomes $33.00 an hour on T1019.
Modifiers define the rate on several codes. Hourly respite on T1005 carries HQ, and daily respite on S5151 carries U8. A claim without the right modifier can be priced on a different rate row or rejected. Daily services (daily respite and adult day) are paid per day rather than per unit.
The July 22 effective date
Because most of Wyoming's home care rates changed on July 22, 2026, any claim with dates of service between July 1 and July 21 should be priced on the earlier schedule, and any visit on or after July 22 on the new one. Billing systems that apply rates by month will misprice those three weeks. Companion care, updated July 1, follows a different date again.
Wyoming publishes rates across nearly every home care line we compare:
| Service | Code | Wyoming rate | Rank | vs national median |
|---|---|---|---|---|
| Personal care (hour) | T1019 | $33.00 | 12 of 27 | +8.1% |
| Companion care (hour) | S5135 | $29.40 | 6 of 20 | +13.3% |
| Homemaker (hour) | S5130 | $26.48 | 6 of 9 | -14.0% |
| Respite (hour) | T1005 (HQ) | $18.72 | 31 of 38 | -26.0% |
| Respite (day) | S5151 (U8) | $168.41 | 24 of 34 | -30.5% |
| Adult day (day) | S5102 | $61.87 | 9 of 12 | -9.9% |
Companion care. S5135 is Wyoming's strongest relative rate, 6th of 20. Vermont ($51.92), South Dakota ($43.24) and Montana ($37.56) lead the ranking.
Homemaker. S5130 pays $6.62 per 15 minutes. Homemaker rates are thin nationally, with only 9 states ranked; Kentucky ($39.00) and North Dakota ($38.36) lead.
Respite. Respite is where Wyoming falls behind. Hourly respite at $18.72 is 26.0% below the $25.30 median, and daily respite at $168.41 is 30.5% below the $242.21 median. Minnesota pays $938.09 a day.
Adult day. S5102 pays $61.87 a day, effective October 1, 2023, the oldest rate in Wyoming's home care set. It ranks 9th of 12 and sits 9.9% below the national median. For an adult day center, a rate that has not moved since 2023 means rising staff and transportation costs have been absorbed without a matching increase, so attendance levels and staffing ratios carry more of the burden each year.
The median wage for home health and personal care aides in Wyoming was $15.96 an hour in May 2025, below the US median of $17.21. Registered nurses earned a median of $40.27, against $46.90 nationally.
A below-median wage paired with above-median rates gives Wyoming agencies workable margins on most services:
- Personal care. The aide wage takes 68.7% of the $33.00 rate, leaving $10.32 an hour after loaded wages.
- Companion care. The wage takes 77.1% of the $29.40 rate, leaving $6.72 an hour.
- Homemaker. The wage takes 85.6% of the $26.48 rate, leaving $3.80 an hour.
- Hourly respite. The wage takes 121.2% of the $18.72 rate, a loss of $3.96 an hour after loaded wages.
Respite is the service that does not pay for itself. An agency offering hourly respite in Wyoming is relying on personal care and companion hours to cover it.
Wyoming's spread of margins, from $10.32 an hour on personal care to a loss on hourly respite, means the service mix decides an agency's results more than any single rate. A few principles follow:
- Lead with personal care. It carries the best margin and the most room to pay aides above the state median.
- Use companion care as a strong second line. At 6th of 20 states, Wyoming's companion rate is better than most, and it can be staffed with a broad workforce.
- Cap hourly respite. Offer it to families already receiving other services, rather than growing it as a standalone line.
- Plan for distance. In a large, rural state, drive time between clients consumes margin. Clustering clients and favoring longer visits protects the margin the rates provide.
These choices are constrained by authorizations, since an agency delivers what the care plan approves. But where an agency chooses which referrals to accept and which services to build, Wyoming's rates give a clear signal.
Wyoming pairs prior authorization with yearly unit limits. In our coverage data:
- S5100 carries 3 prior authorization rules and a yearly limit.
- S5125 and S5130 carry 2 rules each and yearly limits.
- S5135 carries 3 rules and a yearly limit.
- S5151 carries 3 rules; S5101 and S5108 carry 1 each.
- S5102 carries none.
Yearly limits put the burden on scheduling across the plan year. An agency that front-loads companion or homemaker hours can exhaust a client's annual units before the year ends, so units should be tracked against the annual cap from the first visit.
Home care in Wyoming is paid through fee-for-service Wyoming Medicaid and two waiver families:
- Community Choices Waiver, the 1915(c) waiver for elderly and physically disabled adults, which carries homemaker, attendant care and home-delivered meals.
- DD waivers (Comprehensive and Supports), the 1915(c) waivers for people with developmental disabilities.
The same code can carry different rates in each program, so agencies should keep rate tables by program and check that the program on the authorization matches the claim.
Two recent actions shape Wyoming home care:
- Medicaid Rules Ch. 53 Home and Community Based Services Pilot Program, adopted and effective February 20, 2026.
- Benchmarking Appendix F rate history - Waiver Services - Community Choices, SFY 2024, effective March 31, 2025, with a listed change of 12.5%.
The Community Choices benchmarking increase lifted waiver rates in 2025, and the July 22, 2026 update followed. Agencies should check both the effective date and the code modifier when billing, since T1005 and S5151 carry modifiers (HQ and U8) that define the rate.
What the pilot program could mean
A rule chapter that creates a home and community-based services pilot signals that Wyoming is testing new ways to deliver or pay for in-home care. Pilots can introduce new service definitions, new provider types or different payment arrangements for a limited group before any wider rollout. Agencies should read the adopted rule to see whether their services or service areas are included, since early participants in a pilot often help shape the rates and requirements that follow.
Wyoming has no managed-care payment rule for home care: our summary lists no service-line rules for the state, and Wyoming Medicaid is listed as fee-for-service for all enrollees. We have 18 plans and coverage groups on file, including WYhealth Health Management and the Magellan Healthcare care management entity. See the Wyoming managed care page.
For agencies, the fee-for-service model means one payer and one schedule. There is no plan contract to negotiate; rate changes arrive through state schedule updates.
Among neighbors, Utah home care rates lead the country on personal care, Colorado home care rates are the closest comparison to the south, and Montana pays more for companion care. The national home care overview compares every state.
Budgeting. Forecast each service on its own margin; a blended hourly rate hides the respite loss.
Scheduling. Spread authorized units across the plan year so clients do not run out before it ends.
Wage planning. With aide wages below the national median and personal care paying above it, Wyoming agencies have room to raise pay. Fund raises from the personal care margin, not from respite.
Billing. Apply the July 22 effective date by date of service, and use the HQ and U8 modifiers on respite claims.
Rates on this page are compiled from official Wyoming Medicaid publications, including the Wyoming Medicaid Downloadable Fee Schedule and Community Choices Waiver rate history, and each links to its source document. Wyoming's full dataset holds all 47,114 current Wyoming Medicaid rates, with history back to 1994; visit the Wyoming Medicaid rates hub for the full fee schedule. Our methodology explains hourly conversions and ranks.