IDD fully loaded hourly base rate (multiplied by assessed staff hours): Medicaid rates by state

A billing code alone doesn't make a fair comparison: states bill IDD fully loaded hourly base rate (multiplied by assessed staff hours) under different codes, units and provider types. This benchmark lines up one comparable rate per state.

• Provider level. States are compared at the independent (non-agency) provider level. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
• Unit. All 1 states publish their headline rate per hour, so the amounts compare directly. 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. 30 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 $44.23; the lowest, North Dakota, pays $44.23. 1 of the 1 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

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