HCBS rural differential rate (travel-distance tier): Medicaid rates by state

States publish HCBS rural differential rate (travel-distance tier) 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 agency provider level. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. None of the 1 schedules prints a separate unit for their headline rate, so each amount is a flat payment for one service as the code defines it. The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 1 of the 1 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. 48 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, North Dakota, pays $14.85; the lowest, North Dakota, pays $14.85. 1 of the 1 states pay above the median of —. 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.