Home modifications (accessibility): Medicaid rates by state

States publish home modifications (accessibility) 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 self-directed worker (hired by the person or family) level. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. Of the 20 states, 3 publish their headline rate per unit, 2 per lifetime, 1 per n and 6 in other units, and 8 schedules print no unit at all (a flat amount per service). The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 17 of the 20 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. 146 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, Utah, pays $50,000.00; the lowest, Hawaii, pays $1.00, a 50000.0x gap. 20 of the 20 states pay above the median of —. Common reasons rates for other home & community services services spread this way:

• Home and community-based services are often paid under waivers, and each waiver can set its own rate for the same service.
• 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.

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.