IDD Medicaid rates in Kentucky are anchored by one of the country's highest behavior support rates. Kentucky pays $40.24 per 15 minutes for behavior support on code H0004, or $160.96 an hour. That ranks 3rd of 23 states and is 106.2% above the national median of $78.07.
Most other Kentucky IDD services sit close to the national median, and residential and day services sit below it. Every rate on this page has been effective since 2025-01-01. For a provider in Kentucky's Supports for Community Living (SCL) waiver, that means clinical behavior support is well paid while hourly and residential direct support operate on thin margins. Rates are compiled from official state Medicaid publications and link to their source documents.
Kentucky Medicaid IDD reimbursement by service
| Service | Code | Kentucky per hour or day | Rank | vs national median |
|---|---|---|---|---|
| Behavior support | H0004 | $160.96 / hour | 3 of 23 | +106.2% |
| Supported employment | H0039 | $42.16 / hour | 19 of 39 | +3.2% |
| Community integration | 97537 | $26.40 / hour | 12 of 22 | -1.1% |
| Community living supports | 97535 | $33.24 / hour | 17 of 29 | -4.8% |
| Day habilitation | none | $14.48 / hour | 27 of 32 | -37.4% |
| Residential habilitation | T2016 | $198.70 / day | 24 of 31 | -29.1% |
Kentucky has no prevocational or ICF/IID rate in our ranked data.
Behavior support on H0004: top three nationally
Only Maryland ($173.04) and New Hampshire ($167.32) pay more for IDD behavior support than Kentucky's $160.96. Alaska ($136.52) and Connecticut ($132.40) follow. At the bottom, New Jersey pays $33.20, Tennessee $27.00 and Idaho $24.64.
For a behavior support practice, Kentucky's rate is strong enough to fund clinician time, supervision and documentation. Coverage records show 7 prior authorization rules on H0004, so services must be authorized in each person's plan before billing.
Community living supports and community access
Kentucky bills community living supports on 97535 at $8.31 per 15 minutes, or $33.24 an hour, close to the $34.92 median. Most states use T2017 for this service, where South Carolina leads at $85.96.
Kentucky's direct support professional median wage was $18.00 an hour in May 2025 federal data, well below the $22.08 national figure. Loaded with payroll taxes and benefits, that wage takes 74.9% of the 97535 rate, leaving $8.35 an hour.
Community integration on 97537 pays $6.60 per 15 minutes, or $26.40 an hour, essentially at the $26.70 median. Here the loaded wage takes 94.3% of the rate, leaving just $1.51 an hour. One-on-one community access in Kentucky barely covers its direct cost, so providers depend on group delivery or on pairing it with better-paid services.
Coverage records show 9 prior authorization rules on 97535 and 5 on 97537.
Supported employment and day habilitation
Supported employment on H0039 pays $10.54 per 15 minutes, or $42.16 an hour, 3.2% above the $40.84 median. The loaded wage takes 59.0% of the rate, leaving $17.27 an hour, the best direct-support margin on Kentucky's IDD schedule. H0039 carries 6 prior authorization rules.
Day habilitation pays $3.62 per 15 minutes, or $14.48 an hour, 27th of 32 states and 37.4% below the $23.14 median. The lowest states nationally are Texas ($10.98), Louisiana ($9.92) and Indiana ($6.54) at the bottom.
Residential habilitation in Kentucky
Residential habilitation on T2016 pays $198.70 a day, 29.1% below the $280.27 median and 24th of 31 states. It is well short of Minnesota ($999.00) and the District of Columbia ($567.62), and above Iowa ($140.81), Illinois ($108.00) and Oklahoma ($88.66). T2016 carries 5 prior authorization rules.
Kentucky's residential advisor median wage of $14.55 an hour is far below the $20.31 national figure, which helps residential providers operate on a below-median daily rate.
Kentucky wages for IDD roles
May 2025 federal occupational data for Kentucky:
- Direct support professional: $18.00 vs $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $14.55 vs $20.31
- Home health / personal care aide: $17.52 vs $17.21
- Licensed practical nurse: $29.07 vs $30.96
The home health aide median is above the national figure while the direct support median is well below it. IDD agencies in Kentucky compete for workers with home health and personal care employers paying more per hour.
SCL and Michelle P. waivers: how Kentucky pays
Kentucky delivers IDD services through the Supports for Community Living (SCL) waiver and the Michelle P. waiver, under fee schedules set by DMS. Our managed-care classification lists home and community-based services in Kentucky as paid directly by the state, outside managed care, so the published waiver rates are what providers receive. The IDD sheet counts 15 plan listings; see the Kentucky managed care page. Coverage records also show 5 prior authorization rules on S5100, 2 on T2019 and 1 on S9976.
For national medians on all eight services, see the IDD rates by state hub. For all other Kentucky service lines, see the Kentucky Medicaid rates page. Our methodology explains how 15-minute units are converted to hourly rates.
Updated 2026-10-05