IDD Medicaid rates in Wyoming put the state last in the country for job coaching. Wyoming pays $3.09 per 15 minutes for supported employment on code T2019 with modifier UQ, or $12.36 an hour, effective July 22, 2026. That ranks 39th of 39 states and is 69.7% below the national median of $40.84 an hour.
Wyoming is also in the national bottom three for community integration. Yet its in-home supports rate sits just below the national median. The state's IDD schedule pays for one-to-one in-home time far better than it pays for supports delivered out in the community or at work.
T2019 Wyoming Medicaid rate: the lowest supported employment rate
Wyoming's $12.36 hourly supported employment rate is just below West Virginia ($12.80) and Tennessee ($14.96). At the top, New York pays $141.64, Arkansas $102.36, the District of Columbia $97.08, Iowa $79.82 and Missouri $77.80.
The economics do not work for one-to-one job coaching. Wyoming's median direct support wage is $21.77 an hour, close to the national $22.08, and the loaded wage is 243.5% of the T2019 rate, a loss of more than $17 an hour of individual coaching. Supported employment in Wyoming is viable only in group settings or as a service an agency subsidizes from other lines.
T2019 also carries 3 prior authorization rules with a yearly limit.
Wyoming Medicaid IDD reimbursement by service
Wyoming's DD waivers, Comprehensive and Supports, are paid fee-for-service by the Wyoming Department of Health. Agency-provider rates:
| Service | Code | Rate | Rank | vs median |
|---|---|---|---|---|
| In-home and community living supports | T2038 | $33.36/hour | 16 of 29 | -4.5% |
| Residential habilitation | T2016 (U7) | $198.22/day | 25 of 31 | -29.3% |
| Community integration | T2027 | $16.60/hour | 20 of 22 | -37.8% |
| Supported employment | T2019 (UQ) | $12.36/hour | 39 of 39 | -69.7% |
Day habilitation on T2020 is paid at $67.70 a day, effective October 1, 2023. In-home supports and community integration are effective April 1, 2024; residential habilitation and supported employment July 22, 2026.
In-home supports: Wyoming's best-ranked service
In-home and community living supports pay $8.34 per 15 minutes on T2038, or $33.36 an hour, 16th of 29 and only 4.5% below the national median of $34.92. The loaded direct support wage is 90.2% of the rate, leaving $3.26 an hour. That margin is thin, but positive, and it makes in-home supports the one Wyoming IDD service where an agency paying the median wage can cover its direct support hour.
The national range runs from South Carolina ($85.96 on T2017) and South Dakota ($69.28) to Idaho ($15.44), West Virginia ($13.52) and Louisiana ($12.40). Wyoming sits in the middle of the field.
Community integration and residential habilitation
Community integration on T2027 pays $4.15 per 15 minutes, or $16.60 an hour, 20th of 22. Only Louisiana ($16.00) and Georgia ($14.60) pay less. Virginia leads at $140.64. The loaded wage is 181.3% of the rate, a loss of more than $13 an hour on a one-to-one hour.
Residential habilitation on T2016 with modifier U7 pays $198.22 a day, 25th of 31 and 29.3% below the national median of $280.27. Minnesota ($999.00), the District of Columbia ($567.62) and New York ($564.22) lead; Iowa ($140.81), Illinois ($108.00) and Oklahoma ($88.66) are lowest. T2016 carries 5 prior authorization rules.
Direct support wages in Wyoming
Federal occupational wage data for May 2025:
- Direct support professional: $21.77 an hour, versus $22.08 nationally (based on the closest comparable occupation)
- Residential advisor: $16.59, versus $20.31
- Home health and personal care aide: $15.96, versus $17.21
- Licensed practical nurse: $30.51, versus $30.96
The direct support wage is near the national median, which is why Wyoming's low community and employment rates bite so hard: there is no wage discount to offset them. Residential advisors earn well below the national median, which softens the impact of the below-median residential rate somewhat.
Wyoming DD provider rate changes
- 2026 Budget Session, SF0001 (Enrolled Act 27). A Department of Health footnote on DD/ID/ABI provider rates, effective July 1, 2026.
- Waiver Services rate history, Comprehensive and Supports, SFY 2024. A 12.5% rate change effective March 31, 2025, recorded in the benchmarking appendix.
The residential and supported employment rates carry a July 22, 2026 effective date, shortly after the budget act took effect. Providers should watch whether future budget footnotes address the employment and community integration rates, where Wyoming trails nearly every state.
Managed care and coverage rules
Wyoming Medicaid is fee-for-service, and its landscape of 18 plans and coverage groups includes care management programs such as WYhealth Health Management. DD waiver services are paid on the Department of Health's published rates. T2017 carries 4 prior authorization rules with a yearly limit; H2023 and T2020 carry none. The Wyoming managed care page has the details.
The Wyoming 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