ICF/IID payment method parameter: Medicaid rates by state

A billing code alone doesn't make a fair comparison: states bill ICF/IID payment method parameter under different codes, units and provider types. This benchmark lines up one comparable rate per state.

• 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. Of the 3 states, 1 publish their headline rate per bed, 1 per % and 1 per percentile of cost per resident day. The ranking uses the rate as published, so read the unit before comparing two states.
• Variants. 1 of the 3 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. 14 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, Mississippi, pays $165,354.00; the lowest, Alabama, pays $90.00, a 1837.3x gap. 3 of the 3 states pay above the median of —. Common reasons rates for IDD services services spread this way:

• Waiver rates are usually built from a rate model with assumptions about wages, benefits, training and productive time, and states rebuild those models on different schedules.
• Rates vary with staffing ratio, setting and the person's assessed level of support.
• Each waiver can carry its own fee schedule, so one state may publish several rates for the same service.

Billing notes

Modifiers often identify the staffing ratio or support tier, and each carries its own rate. Day services and supported employment are commonly billed in 15-minute units or per day; residential services per day or per month.