IDD Medicaid rates in Delaware rank near the top of the country on almost every service except one. Delaware pays $60.49 an hour for community living supports on code T2013, effective 2024-07-01. That ranks 6th of 29 states and is 73.2% above the national median of $34.92.
Delaware is in the top ten for community living supports, community integration, day habilitation, prevocational services and behavior support. The exception is supported employment, where it ranks 35th of 39 states at $18.08 an hour. That contrast is the defining feature of Delaware's IDD schedule, and it matters for any provider deciding which services to offer under the DDDS Lifespan waiver. Rates are compiled from official state Medicaid publications and link to their source documents.
| Service | Delaware per hour | Rank | vs national median |
|---|---|---|---|
| Community living supports (T2013) | $60.49 | 6 of 29 | +73.2% |
| Prevocational services | $45.60 | 5 of 28 | +144.2% |
| Day habilitation | $45.60 | 7 of 32 | +97.1% |
| Community integration | $39.24 | 5 of 22 | +47.0% |
| Behavior support | $87.36 | 9 of 23 | +11.9% |
| Supported employment | $18.08 | 35 of 39 | -55.7% |
Residential habilitation is published as an hourly rate of $41.83, effective 2024-07-01, so Delaware is not ranked against states that pay group homes per day. Delaware has no ICF/IID rate in our data.
Five of the six ranked services sit in the top ten. The sixth sits in the bottom five. Few states show a single service so far out of line with the rest of their schedule, and that gap shapes the choices Delaware agencies make about what to offer.
Delaware's IDD services run mainly through the Delaware DDDS Lifespan 1915(c) HCBS waiver, administered by the Division of Developmental Disabilities Services. A 1915(c) waiver lets the state pay for community services as an alternative to institutional care, and the Lifespan waiver covers people across age groups rather than splitting children and adults into separate programs.
Units
Most Delaware IDD services bill in 15-minute units: day habilitation and prevocational services at $11.40 per unit, community integration at $9.81, behavior support at $21.84 and supported employment at $4.52. Community living supports on T2013 and residential habilitation are published per hour. Our methodology explains how units are converted so Delaware can be compared with states using different conventions.
Hourly residential rates
Paying residential habilitation by the hour, at $41.83, is unusual. A daily rate puts the risk of staffing a 24-hour home on the provider; an hourly rate ties payment to the hours of support actually delivered and documented. For a Delaware group home operator, that means timekeeping and documentation drive revenue directly, and shift schedules must match authorized hours closely.
Delaware bills community living supports on T2013 rather than the T2017 used in most states, and pays $60.49 an hour. Only five states pay more, led by South Carolina ($85.96), South Dakota ($69.28) and Massachusetts ($68.04), with Alaska ($61.84) and Maryland ($61.32) just ahead.
The rate leaves an unusually large margin. Delaware's direct support professional median wage was $19.57 an hour in May 2025 federal data. Loaded with payroll taxes and benefits, that wage takes 44.7% of the T2013 rate, leaving $33.43 an hour. Community integration, at $9.81 per 15 minutes or $39.24 an hour, leaves $12.18 after a loaded wage that takes 69.0% of the rate.
Coverage records show T2013 carries 2 prior authorization rules and a limit on hours per year, so the high rate applies within an authorized annual budget. In practice the binding constraint for a Delaware agency is not the rate but the number of authorized hours and the staff to fill them.
Delaware pays the same $11.40 per 15 minutes, or $45.60 an hour, for both day habilitation and prevocational services. Because the national medians differ, the identical rate ranks differently: 7th of 32 for day habilitation (97.1% above the $23.14 median) and 5th of 28 for prevocational services (144.2% above the $18.67 median).
Delaware's prevocational rate trails only Oregon ($74.31), Minnesota ($69.42), Utah ($60.68) and Alaska ($49.32). Its community integration rate trails only Virginia, Indiana, Maryland and the District of Columbia, at $140.64, $104.56, $68.44 and $51.64. For a Delaware day program, prevocational, day and community integration time all pay well above national norms.
Because the two day services pay the same, the choice between them can rest on what each participant needs rather than on revenue. That is not true in many states, where a rate gap pushes programs toward one model.
Behavior support pays $21.84 per 15 minutes, or $87.36 an hour, 9th of 23 states and 11.9% above the $78.07 national median. It is the Delaware service closest to the national middle among those that rank well. Behavior support is clinician-led work, and the rate has to cover a credentialed professional's time, so the margin depends on the clinician wages an agency pays rather than the direct support median. The code T2025 carries 1 prior authorization rule.
Supported employment pays $4.52 per 15 minutes, or $18.08 an hour. That is 55.7% below the $40.84 median and 35th of 39 states. The lowest rates nationally are in Tennessee ($14.96), West Virginia ($12.80) and Wyoming ($12.36). At the top, New York pays $141.64.
The rate is below the $19.57 median direct support wage. The loaded wage is 149.7% of the rate, a shortfall of $8.98 for every hour of one-on-one job coaching. Coverage records also show 11 prior authorization rules on T2019, the most of any Delaware IDD code.
Pathways to Employment
Supported employment runs partly through Delaware's Pathways to Employment program, a 1915(i) State Plan HCBS benefit. Its SFY2025 provider rates, effective 7/1/2024, carried a 43.35% change, and SPA DE 24-0013 was approved 12/20/2024 with an effective date of 1/1/2025. Providers should check which program and rate apply to each person they support, because the same service can pay differently depending on whether it is authorized under the Lifespan waiver or Pathways.
Delaware has moved its IDD rates several times:
- Lifespan Waiver SFY2025 rates: a 7.63% change, effective 7/1/2024.
- Minimum wage level-up: DDDS Lifespan Waiver rates were leveled up to the $15/hr state minimum wage, a 6.31% change effective 1/1/2025.
- Targeted case management: DDDS TCM monthly rates changed 2.9% for SFY2025 and 2.6% for SFY2026, effective 7/1/2025.
- Pathways to Employment: the 43.35% SFY2025 change and the 1915(i) SPA described above.
The minimum wage level-up is a reminder that Delaware's rates are tied to wage assumptions. When the state minimum wage moves, providers should watch for a corresponding rate action.
Delaware wages for IDD roles are below the national median except for nursing:
- Direct support professional: $19.57 vs $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $16.60 vs $20.31
- Home health / personal care aide: $16.50 vs $17.21
- Licensed practical nurse: $33.03 vs $30.96
Below-median wages combined with top-ten rates give Delaware agencies room to pay above the local median on most services, which is the most direct lever for reducing turnover.
Delaware's managed care runs through the Diamond State Health Plan and DSHP Plus, with plans including AmeriHealth Caritas Delaware, Delaware First Health and Highmark Health Options; Delaware's IDD plan listings count 5 entries. Those plans do not set IDD rates. Our managed-care classification lists intellectual and developmental disability services, home and community-based services and personal care as paid directly by the state, outside managed care. See the Delaware managed care page.
Delaware's position is easiest to see at the two ends of its schedule. On community living supports, its $60.49 rate is close to the very top of the country and several times what the lowest states pay: Idaho $15.44, West Virginia $13.52 and Louisiana $12.40. On supported employment, the picture reverses. Delaware's $18.08 sits just above the bottom group and less than a third of what the leading states pay.
For an agency that operates in several states, this means a Delaware program should not be modeled on the same service mix as a program elsewhere. A model built around job coaching, viable in a state like New York, would struggle in Delaware; a model built around in-home and day supports would earn more in Delaware than in most of the country. Small states can change their schedules quickly, so the comparison is worth revisiting each fiscal year.
- Lead with in-home and day services. These carry the widest margins on Delaware's schedule.
- Price supported employment honestly. At $18.08 an hour, decide in advance whether the service will be subsidized and by how much.
- Track annual hour limits on T2013. Monitor authorized hours used against each person's annual budget.
- Document residential hours carefully. With an hourly residential rate, unrecorded support is unpaid support.
Rates on this page are compiled from official state Medicaid publications, including DDDS Lifespan waiver and Pathways to Employment rate schedules, and each rate links to its source document. Hourly figures are derived from published 15-minute or hourly units. National ranks compare agency-provider rates for the same service across states that publish one, and wage figures are May 2025 federal occupational medians. All 46,693 current Delaware Medicaid rates are available with an account; see pricing, the IDD rates by state hub and the Delaware Medicaid rates page.