Employment supports (HCBS, non-IDD): Medicaid rates by state

States publish employment supports (HCBS, non-IDD) under their own codes, modifiers and units. To compare them, this page picks the rate in each state that matches the same service and provider level.

• Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. All 2 states publish their headline rate per 15 min, so the amounts compare directly. The ranking converts every time-based rate to an hour of service, so states that bill by the 15 minutes and by the hour compare directly.
• Variants. 1 of the 2 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
• Depth. 7 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.

The highest-paying state, Idaho, pays $45.76 per hour; the lowest, Vermont, pays $26.40 per hour, a 1.7x gap. 1 of the 2 states pay above the median of $36.08 per hour. Common reasons rates for other home & community services services spread this way:

• Some services are paid per 15 minutes in one state and per day or per month in another.
• Case management may be paid as a monthly rate, a per-contact rate or in 15-minute units.
• Home and community-based services are often paid under waivers, and each waiver can set its own rate for the same service.

Billing notes

Units range from 15 minutes to a day or a month, so a per-unit comparison only holds when the states use the same unit.