IDD Medicaid rates in Washington are best understood against the state's wages. Washington pays $60.00 an hour for behavior support services on DDA code SA040 with modifier U1, effective July 1, 2025. That ranks 18th of 23 states and is 23.1% below the national median of $78.07 an hour.
At the same time, Washington's labor market for IDD staff runs well above national levels on every role. A direct support professional earns a median $26.33 an hour in Washington, against $22.08 nationally. That combination of below-median clinical rates and above-median wages is the defining feature of Washington's IDD picture, and it means national benchmarks understate how tight Washington's margins can be.
Behavior support is the Washington IDD service ranked in the national comparison. At $60.00 an hour, Washington is in the lower third. The top of the range is Maryland ($173.04), New Hampshire ($167.32), Kentucky ($160.96), Alaska ($136.52) and Connecticut ($132.40). The bottom is New Jersey ($33.20), Tennessee ($27.00) and Idaho ($24.64).
Behavior support is delivered by clinicians who assess behavior, write support plans and train staff. In a state where clinical wages run high (LPNs earn a median $39.98 an hour, against $30.96 nationally), a $60.00 hourly rate for clinical behavior work is tight once supervision, documentation and travel are added.
Making the behavior support rate work
Providers in this position typically protect clinician time. That means grouping visits by geography, using structured staff training sessions that serve several people's plans at once where appropriate, and building documentation templates that capture required data without adding unbilled hours. Agencies that can show strong outcomes, such as reduced crisis incidents or fewer placement breakdowns, also have the clearest case when DDA revisits rates.
Washington's Developmental Disabilities Administration (DDA) pays IDD services under its waiver and state plan programs: Basic Plus, Core, IFS, CIIBS and CP. Separate rate tables cover residential settings: DDA group homes, group training homes, staffed residential homes, supported living and the community protection program. Each setting has its own rate structure, so a provider running several types of service works from several tables.
DDA publishes its rates with state-specific SA codes rather than only national HCPCS codes. Beyond behavior support, the residential habilitation line on SA727 with modifier U1 is published at $9.79, effective January 1, 2026, on DDA's own unit basis. Because the unit is DDA-specific, that figure cannot be compared directly with daily residential rates in other states.
Washington is unusual in how finely it separates residential IDD settings. Group homes, group training homes, staffed residential homes, supported living and the community protection program each carry their own DDA rate table, and the group home and group training home tables share a common structure. For a provider, the setting determines the rate, the staffing expectations and the reporting.
Supported living, where people live in their own homes with staff support, is usually priced around the hours of support each person needs, so the rate tracks staffing closely. Group settings are priced per resident, which rewards stable occupancy. Community protection serves people who need intensive supervision for safety reasons, and its rates reflect higher staffing.
The practical advice is to model each setting separately. A provider that runs supported living and a group home should not blend their margins: a vacancy hurts a group home immediately, while a staffing shortfall hurts supported living. Keeping the two apart in budgets shows which model is carrying the agency.
The national IDD comparison ranks Washington only on behavior support. For DDA providers in other service lines, the national medians are useful benchmarks: $34.92 an hour for in-home and community living supports, led by South Carolina at $85.96 on T2017; $23.14 an hour for day habilitation, led by Minnesota at $100.00 on T2021; $40.84 an hour for supported employment on codes such as T2019; and $280.27 a day for residential habilitation, with Minnesota's $999.00 on T2016 at the top.
Those medians reflect a national wage base. In Washington, any comparison has to start from a direct support wage that is far higher, so a DDA rate equal to the national median would leave a Washington provider with much less margin than a provider in a median-wage state.
Federal occupational wage data for May 2025 shows Washington well above the national median on every IDD role:
| Role | Washington | US median |
|---|---|---|
| Direct support professional | $26.33 | $22.08 |
| Residential advisor | $23.38 | $20.31 |
| Home health / personal care aide | $22.95 | $17.21 |
| Licensed practical nurse | $39.98 | $30.96 |
The direct support figure is based on the closest comparable federal occupation. The gap is largest for personal care aides: $22.95 in Washington against $17.21 nationally. Washington IDD agencies compete for workers with home care agencies that pay far above national norms.
For a provider comparing Washington with other states, this means a rate that would leave a healthy margin in a median-wage state may leave little or nothing here. Any national benchmark has to be read against a $26.33 direct support wage, not the $22.08 national figure.
The personal care wage is the more immediate competitor. When a home care agency pays close to what a DDA provider pays, a job seeker will weigh schedule, travel and workload rather than pay alone. DDA providers that cannot outbid on wages tend to compete on predictable schedules, paid training and clear advancement paths into lead and supervisory roles. The July 2025 rate increase for DDCS waiver providers is the kind of change that makes a wage premium possible, and providers should decide in advance how much of each increase will go to frontline pay.
On behavior support, Washington sits much nearer the low end of the national range than the high end. Maryland's $173.04 and New Hampshire's $167.32 show what a top-paying state allows for clinical time, while Idaho's $24.64 shows the floor. Washington's 23.1% gap to the national median places it among states where behavior support providers depend on efficient caseloads and careful scheduling to cover clinician costs. Given Washington's wage levels, that gap weighs more heavily than the same gap would in a lower-wage state.
Among Pacific neighbors, Oregon tops the country on prevocational services and ranks high on residential habilitation, and Alaska ranks in the top four on behavior support at $136.52 an hour.
Washington updates DDA rates through change logs and management bulletins rather than one annual edition:
- DDA Management Bulletin D25-004 (July 1, 2025). Rate increases of 10.04% for DDCS waiver service providers.
- DDA Management Bulletin D25-003 (published June 10, 2025). Changes to Adult Family Home (AFH) respite rates, effective July 1, 2025.
- DDA change log, July 23, 2025. All DDCS rates were recalculated to reflect an increase in the ISS rate component.
- DDA change log, August 26, 2025. The old SA727 U1 procedure rate was removed and SA727 U1 taxonomy rates updated.
- DDA change logs, November 4 and December 15, 2025. Updated rates for SA077 U1, SA080 and SA719 U3; SA422 and SA452 removed.
For providers, the practical point is that DDA rates can change mid-year, code by code. Billing teams should check the current DDA rate table before each billing cycle rather than relying on an annual update.
HCS Management Bulletin H26-028 covered July 1, 2026 rates for Home and Community Services and the Developmental Disabilities Administration, and H26-035 set a 5.79% change to the home care agency vendor rate the same day. Because DDA and home care draw on the same workforce, the home care vendor rate is a signal for DDA providers too: when it rises, competition for direct care staff rises with it. A public notice on DSHS's DDA Medicaid waiver applications under Section 1915(c) Appendix K authority, effective August 1, 2026, is also worth reading for any temporary flexibilities it grants.
In Washington, both intellectual and developmental disability services and home and community-based services are paid directly by the state, outside managed care. Washington Apple Health includes 51 plans and arrangements, including Community Health Plan of Washington and Amerigroup, but DDA services are paid on DDA's own rate tables. The Washington managed care page has each line's rule.
DDA codes SA210, SA211, SA216, SA370, SA722, SA835 and SA836, along with T2033, carry no prior authorization rules in the state's coverage listing. The person's DDA service plan sets what a provider can bill. Direct state payment also means there is no plan contract to negotiate: one DDA rate applies statewide, and changes arrive through bulletins and change logs rather than through plan renegotiation. Providers that also serve Apple Health members for medical or behavioral health services deal with plans for that work only.
- Benchmarking. Compare DDA rates with national medians only after adjusting for Washington's wage levels.
- Billing. Check DDA change logs each cycle; codes change mid-year.
- Wage planning. Decide how each increase, such as the 10.04% July 2025 change, flows to frontline pay.
- Behavior support. Protect clinician time through scheduling and documentation design.
The Washington Medicaid rates hub covers all 42,408 current Washington Medicaid rates, including every DDA rate table, and IDD Medicaid rates by state compares every IDD service.
Rates are compiled from official state Medicaid publications, including the DSHS ORM "All DDA Rates" publication, DDA management bulletins and the Home and Community Based Rates History. Each rate links to its source document and carries its effective date. National medians and ranks compare agency-provider rates for the same service across states. See our methodology.