IDD Medicaid rates in Rhode Island put day programs near the top of the country. Rhode Island pays $13.03 per 15 minutes for day habilitation on code T2021, or $52.12 an hour, effective October 1, 2026. That ranks 3rd of 32 states and is 125.3% above the national median of $23.14 an hour.
The October 2026 rates are new. Rhode Island's FY2027 waiver rates, set under Budget Article 8, carry a 10.64% change effective October 1, 2026, pending CMS approval. The October 1, 2026 effective dates on this page line up with that change.
Rhode Island Medicaid IDD reimbursement by service
Rhode Island's developmental disabilities services are run by BHDDH and paid on a fee-for-service basis. Agency-provider rates:
| Service | Code | Rate | Rank | vs median | Effective |
|---|---|---|---|---|---|
| Day habilitation | T2021 | $52.12/hour | 3 of 32 | +125.3% | Oct 1, 2026 |
| ICF/IID stay | — | $734.52/day | 4 of 12 | +58% | Apr 1, 2022 |
| Residential habilitation | T2016 (L9) | $246.00/day | 20 of 31 | -12.2% | Jul 1, 2011 |
| Supported employment | T2019 (UP) | $25.64/hour | 30 of 39 | -37.2% | Oct 1, 2026 |
Two more rates are listed as published: in-home and community living supports on T2017 with modifier UP at $8.98 (October 1, 2026), and prevocational services on T2015 with modifier UQ at $230.81 an hour (September 1, 2023).
T2021 Rhode Island Medicaid rate: day habilitation
Day habilitation at $52.12 an hour is Rhode Island's best-ranked service. Only Minnesota ($100.00) and Connecticut ($57.28) pay more, and Rhode Island is just ahead of California ($50.77) and Massachusetts ($50.40). At the bottom of the range are Texas ($10.98), Louisiana ($9.92) and Indiana ($6.54 on T2020).
For a Rhode Island day program, a rate more than double the national median is enough to fund smaller groups and individualized community activities. It also has to absorb direct care wages well above the national median, covered below.
Residential habilitation and ICF/IID
Rhode Island's residential habilitation rate of $246.00 a day on T2016 with modifier L9 has been in effect since July 1, 2011. It ranks 20th of 31, 12.2% below the national median of $280.27. Minnesota ($999.00), the District of Columbia ($567.62) and New York ($564.22) top the list; Iowa ($140.81), Illinois ($108.00) and Oklahoma ($88.66) are lowest.
The ICF/IID daily rate of $734.52, effective April 1, 2022, ranks 4th of 12, 58% above the national median of $464.88. Only the District of Columbia ($1,021.84), Maine ($995.49) and South Dakota ($926.97) pay more.
The contrast is sharp: Rhode Island pays near the top for facility-based care and below the median for community residential habilitation.
Supported employment and the wage problem
Supported employment is Rhode Island's weakest rate: $6.41 per 15 minutes on T2019 with modifier UP, or $25.64 an hour, 30th of 39 and 37.2% below the national median of $40.84.
Federal occupational wage data for May 2025 shows why that matters:
- Direct support professional: $22.94 an hour, versus $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $21.77, versus $20.31
- Home health and personal care aide: $21.00, versus $17.21
- Licensed practical nurse: $38.51, versus $30.96
At those wages, supported employment loses money on every one-to-one hour. The loaded direct support wage is 123.7% of the T2019 rate, a loss of more than $6 an hour. Rhode Island's personal care aide wage, at $21.00, is also far above the national median, so IDD providers compete for staff against home care agencies paying well above the national norm.
FY2027 rate increase and recent BHDDH changes
Rhode Island's DD rates have moved quickly in the last two years:
- FY2027 Waiver Rates (Budget Article 8). Enacted September 2026 with a 10.64% change effective October 1, 2026, pending CMS approval. Its effective date matches the October 2026 rates on this page.
- OHIC Social and Human Service Programs Review, 2025 cycle. Published August 29, 2025, recommending a 9.2% rate change.
- DD Services Rate Table FY26. Revised March 17, 2026, with rates effective July 1, 2025.
- CMS-approved SPA 24-0015. Approved December 17, 2024, effective August 15, 2024.
- BHDDH DD FY25 Billing Communication and FAQs. Issued September 10, 2024 for rates effective July 1, 2024.
The enacted FY2027 change exceeds OHIC's recommended 9.2%. For providers, the caveat is the pending CMS approval: the October 2026 rates depend on it.
Prior authorization and daily limits
Rhode Island's DD codes carry heavy authorization rules, almost all with daily limits. T2033 has 41 rules, T2017 has 40, T2021 has 34, and T2016 and T2019 each have 24. T2015 has 7 and H2023 has 4; T2020 has none. Billing teams should expect day-by-day unit tracking on nearly every DD service.
Managed care and Rhode Island DD services
In Rhode Island, both intellectual and developmental disability services and home and community-based services are paid directly by the state, outside managed care. Rhode Island has 12 plans in its landscape, including Neighborhood Health Plan of Rhode Island, Tufts Health Public Plans and UnitedHealthcare Community Plan of Rhode Island, but DD providers bill BHDDH's fee-for-service rates. The Rhode Island managed care page has each line's rule.
The Rhode Island Medicaid rates hub covers the full fee schedule, and IDD Medicaid rates by state compares every IDD service. Rates are compiled from official state Medicaid publications with links to their source documents; see our methodology.
Updated 2026-10-05