Administrative Letter 24-02
Dear Providers,
Developmental Disabilities Services (DDS) received approval from the Centers for Medicare and Medicaid (CMS) for a rate increase effective Oct. 1, 2024.
The rate changes and structure are fixed, and uniform as established through the Oklahoma Health Care Authority’s (OHCA) State Plan Amendment Rate Committee (SPARC). The services, current service codes and rates are outlined in this document.
For providers and agencies with waiver authorizations from the Oklahoma Healthcare Authority, there is no action required. Rate tables have been updated to reflect the new rates, and there is no need to split or re-submit claims. Group Home Authorizations require end dating the current authorization and creation of a new authorization effective Oct. 1 with the new rate. This project will be completed by the DDS Provider Support Center. For state funded services, providers will need to update their invoices to reflect the new rates effective Oct. 1, 2024.
Additionally, the annual financial limit for In-Home Supports Waivers (IHSW) will increase by 25% effective Oct. 1, 2024. The new annual limit for IHSW for adults is $36,143 and the new annual limit for IHSW for children is $24,104.
IHSW Adult recipients can also receive additional employment services, above the new limit. IHSWA recipients will now be able to access an additional $7,562.50 each year in employment services.
Community waiver and Homeward Bound waiver recipients can access a total of $60,245.90 for a combination of prevocational and employment services.
The new rates are described and outlined below.
Description |
Previous Annual Limit |
New Annual Limit |
In-Home Supports Waivers - Adult |
$28,914 |
$36,143 |
In-Home Supports Waivers - Children |
$19,283 |
$24,104 |
Waiver Rate Description |
Service Code |
Service Unit |
Current Rate |
Proposed Rate |
||
Transportation - Adapted |
A0130 |
|
|
Mile |
1.69 |
1.86 |
Self-Directed – Transportation (adapted) |
A0130 |
UA |
|
Mile |
1.69 |
1.86 |
Transportation - Adapted - AC/SFC Providers |
A0130 |
|
|
Mile |
1.69 |
1.86 |
Skilled Nursing - Registered Nurse |
G0299 |
|
|
15 minutes |
19.50 |
21.45 |
Skilled Nursing - Licensed Practical Nurse |
G0300 |
|
|
15 minutes |
18.20 |
20.02 |
Adult Day Services |
S5100 |
|
|
15 minutes |
2.60 |
2.86 |
Agency Companion - Enhanced |
S5126 |
|
|
Day |
163.15 |
179.47 |
Agency Companion - Pervasive |
S5126 |
TF |
|
Day |
178.43 |
223.04 |
Agency Companion - Pervasive - Therapeutic Leave |
S512 |
TF |
TV |
Day |
178.43 |
223.04 |
Agency Companion - Enhanced - Therapeutic Leave |
S5126 |
TV |
|
Day |
163.15 |
179.47 |
Agency Companion - Close |
S5126 |
U1 |
|
Day |
125.45 |
138.00 |
Agency Companion - Close Therapeutic Leave |
S5126 |
U1 |
TV |
Day |
125.45 |
138.00 |
Homemaker |
S5130 |
|
15 minutes |
5.00 |
6.25 |
|
Specialized Family Care Adult - Maximum |
S5140 |
|
Day |
70.20 |
77.22 |
|
Specialized Family Care Adult (Maximum) Therapeutic Leave |
S5140 |
TV |
|
Day |
70.20 |
77.22 |
Specialized Family Care Child - Maximum |
S5145 |
|
Day |
70.20 |
77.22 |
|
Specialized Family Care Child (Maximum) Therapeutic Leave |
S5145 |
TV |
|
Day |
56.16 |
61.78 |
Respite - Hourly |
S5150 |
|
15 minutes |
5.00 |
5.50 |
|
Respite - Maximum |
S5151 |
|
Day |
98.80 |
108.68 |
|
Respite in Community Living Group Home 10 Bed Setting |
S5151 |
|
Day |
185.58 |
204.14 |
|
Respite in Community Living Group Home 11 Bed Setting |
S5151 |
|
Day |
171.28 |
188.41 |
|
Respite in Community Living Group Home 12 Bed Setting |
S5151 |
|
Day |
169.65 |
186.62 |
|
Respite in Community Living Group Home 6 Bed Setting |
S5151 |
|
Day |
245.38 |
269.92 |
|
Respite in Community Living Group Home 7 Bed Setting |
S5151 |
|
Day |
214.50 |
235.95 |
|
Respite in Community Living Group Home 8 Bed Setting |
S5151 |
|
Day |
208.33 |
229.16 |
|
Respite in Community Living Group Home 9 Bed Setting |
S5151 |
|
Day |
188.18 |
207.00 |
|
Respite in Agency Companion - Contractor - Close |
S5151 |
|
Day |
154.05 |
169.46 |
|
Respite in Agency Companion - Contractor- Enhanced |
S5151 |
|
Day |
191.75 |
210.93 |
|
Respite in Agency Companion - Contractor - Pervasive |
S5151 |
|
Day |
207.03 |
227.73 |
|
Respite in Group Home - 10 Bed Setting |
S5151 |
|
Day |
88.08 |
96.89 |
|
Respite in Group Home - 11 Bed Setting |
S5151 |
|
Day |
84.18 |
92.60 |
|
Respite in Group Home - 12 Bed Setting |
S5151 |
|
Day |
80.93 |
89.02 |
|
Respite in Group Home - 6 Bed Setting |
S5151 |
|
Day |
123.38 |
135.72 |
|
Respite in Group Home - 7 Bed Setting |
S5151 |
|
Day |
109.20 |
120.12 |
|
Respite in Group Home - 8 Bed Setting |
S5151 |
|
Day |
99.13 |
109.04 |
|
Respite in Group Home - 9 Bed Setting |
S5151 |
|
Day |
92.95 |
102.25 |
|
Respite - Close |
S5151 |
TF |
|
Day |
50.00 |
55.00 |
Respite - Intermittent |
S5151 |
U1 |
|
Day |
23.75 |
26.13 |
Respite, In Own Home - Maximum |
S9125 |
|
Day |
71.30 |
78.43 |
|
Respite, In Own Home - Close |
S9125 |
TF |
|
Day |
35.63 |
39.19 |
Respite, In Own Home - Intermittent |
S9125 |
U1 |
|
Day |
23.75 |
26.13 |
Nursing - Extended Duty Care |
T1000 |
|
15 minutes |
10.00 |
11.00 |
|
Nursing - Intermittent Skilled Care |
T1001 |
|
Visit |
65.65 |
72.22 |
|
DLS - Therapeutic Leave |
T2033 |
TV |
|
Day |
200.20 |
225.23 |
Group Home 6 Bed |
T1020 |
|
Day |
94.25 |
103.68 |
|
Group Home 7 Bed |
T1020 |
|
Day |
80.60 |
88.66 |
|
Group Home 8 Bed |
T1020 |
|
Day |
70.53 |
77.58 |
|
Group Home 9 Bed |
T1020 |
|
Day |
64.35 |
70.79 |
|
Group Home 10 Bed |
T1020 |
|
Day |
59.48 |
65.43 |
|
Group Home 11 Bed |
T1020 |
|
Day |
55.58 |
61.14 |
|
Group Home 12 Bed |
T1020 |
|
Day |
52.33 |
57.56 |
|
Group Home Alternative Living |
T1020 |
|
Day |
379.60 |
427.05 |
|
Group Home Community Living 10 Bed |
T1020 |
|
Day |
156.98 |
172.68 |
|
Group Home Community Living 11 Bed |
T1020 |
|
Day |
142.68 |
156.95 |
|
Group Home Community Living 12 Bed |
T1020 |
|
Day |
141.05 |
155.16 |
|
Enhanced Community-Based Pre-Voc Svc |
T2015 |
|
Hour |
17.31 |
19.04 |
|
Community-Based Pre-Voc Svc |
T2015 |
TF |
|
Hour |
13.00 |
14.30 |
Pre-Voc HTS - Supplemental Supports |
T2015 |
TG |
|
Hour |
16.38 |
18.02 |
Center-Based Pre-Vocational Svc |
T2015 |
U1 |
|
Hour |
6.50 |
7.15 |
Individual Placement in Community-Based, Pre-Vocational |
T2015 |
U4 |
|
Hour |
21.05 |
23.16 |
Individual Placement in Community-Based, Pre-Vocational - Telehealth |
T2015 |
U4 |
GT |
Hour |
21.05 |
23.16 |
HTS - Habilitation Training Specialist |
T2017 |
|
15 minutes |
5.26 |
6.58 |
|
HTS - Habilitation Training Specialist - EVV |
T2017 |
32 |
|
15 minutes |
5.26 |
6.58 |
Intensive Personal Supports |
T2017 |
TF |
|
15 minutes |
5.26 |
6.58 |
Self-Directed HTS |
T2017 |
U1 |
TF |
15 minutes |
5.26 |
6.58 |
Remotes Supports with Paid Staff |
T2017 |
U4 |
|
15 minutes |
3.28 |
3.61 |
Remote Supports with Unpaid Staff |
T2017 |
U4 |
R1 |
15 minutes |
1.81 |
1.99 |
Employment Specialist |
T2019 |
|
15 minutes |
7.85 |
8.64 |
|
Job Coaching (Groups of 2-3) |
T2019 |
HQ |
|
15 minutes |
4.69 |
5.16 |
Job Coaching (Groups of 4-5) |
T2019 |
TF |
|
15 minutes |
4.34 |
4.77 |
Enhanced Job Coaching Service (Groups of 4-5) |
T2019 |
TG |
|
15 minutes |
5.05 |
5.56 |
Enhanced Job Coaching (Groups of 2-3) |
T2019 |
TG |
HQ |
15 minutes |
5.40 |
5.94 |
Job Stabilization/Extended Svc |
T2019 |
U1 |
|
15 minutes |
1.80 |
1.98 |
Individual Placement in Job Coaching, Supported Employment |
T2019 |
U4 |
|
15 minutes |
7.81 |
8.59 |
Individual Placement in Job Coaching, Supported Employment - Telehealth |
T2019 |
U4 |
GT |
15 minutes |
7.81 |
8.59 |
Self-Directed Individual Placement in Job Coaching, Supported Employment |
T2019 |
U4 |
TF |
15 minutes |
7.81 |
8.59 |
Value-Based Incentive Quality Payment |
T2025 |
UK |
|
Each |
625.00 |
687.50 |
Daily Living Supports |
T2033 |
|
Day |
200.20 |
225.23 |
|
Extensive Residential Supports |
T2033 |
TG |
|
Day |
929.92 |
1,046.16 |
Self-Directed Individual Placement in Community Based Pre-Vocational Services |
T2015 |
U4 |
UA |
15 minutes |
21.05 |
23.16 |
Self-Directed Individual Placement in Community Based Pre-Vocational Services Telehealth |
T2015 |
U4 |
UA |
15 minutes |
21.05 |
23.16 |
Extensive Residential Supports - Therapeutic Leave |
T2033 |
TG |
TV |
Day |
929.92 |
1,046.16 |
Please note: Rate increases for the following are being finalized, and we’ll provide an update as soon as possible:
- Group Home Community Living 6 Bed
- Group Home Community Living 7 Bed
- Group Home Community Living 8 Bed
- Group Home Community Living 9 Bed
2024 Provider RateIncreases: State Rates
Program |
Service Units |
Current Cap |
Proposed Cap |
Service Unit |
Current Rate |
New |
| State Rate: Assisted Living |
N/A |
N/A |
N/A |
Day |
$24.06 |
$26.47 |
| State Rate: Individual Placement (CIE) |
370 hours |
$12,258.10 |
$13,483.91 |
Day |
$33.13 |
$36.45 |
| State Rate: Follow-Along (CIE) |
315 hours |
$10,435.95 |
$11,479.55 |
Day |
$33.13 |
$36.45 |
| State Rate: Group Placement (CIE) |
292 hours |
$9,673.96 |
$10,641.36 |
Day |
$33.13 |
$36.45 |
| State Rate: Assessment (CIE) |
20 hours |
$662.60 |
$728.86 |
Day |
$33.13 |
$36.45 |
State Rate: |
40 hours |
$1,325.00 |
$1,457.50 |
Day |
$33.13 |
$36.45 |
| State Rate: Group Home, 6 Bed |
N/A |
N/A |
N/A |
Day |
$94.25 |
$103.68 |
State Rate: |
N/A |
N/A |
N/A |
Day |
$80.60 |
$88.66 |
| State Rate: Group Home, 8 Bed |
N/A |
N/A |
N/A |
Day |
$70.53 |
$77.59 |
| State Rate: 9 Bed |
N/A |
N/A |
N/A |
Day |
$64.35 |
$70.79 |
| State Rate: 10 Bed |
N/A |
N/A |
N/A |
Day |
$59.48 |
$65.43 |
| State Rate: 11 Bed |
N/A |
N/A |
N/A |
Day |
$55.58 |
$61.14 |
| State Rate: 12 Bed |
N/A |
N/A |
N/A |
Day |
$52.33 |
$57.57 |
| State Rate: Prader Willi |
N/A |
N/A |
N/A |
Day |
$54.94 |
$60.44 |
| State Rate: Sheltered Workshop |
N/A |
N/A |
N/A |
5-hour Day |
$30.28 |
$33.31 |
| Adult Day: Full Day |
N/A |
N/A |
N/A |
Full Day |
$10.00 |
$11.00 |
| Adult Day: Part Day |
N/A |
N/A |
N/A |
Part Day |
$6.00 |
$6.60 |
If you have questions or concerns, please send an email to TellDDS@okdhs.org.
Sincerely,
Beth Scrutchins, Director
Developmental Disabilities Services
Oklahoma Human Services
