5% Rate Increase for Some Children’s Long-Term Support Program Providers
The Wisconsin Department of Health Services is increasing the rates for certain providers of Medicaid home and community-based services (HCBS) by 5% to address the severe staffing shortage in the direct care workforce and strengthen participants’ access to services. This rate increase is effective with dates of service January 1, 2022, and after.
Where is the funding coming from?
This rate increase is funded by the American Rescue Plan Act (ARPA). ARPA's economic stimulus package includes funding to qualifying states to support and strengthen their HCBS programs.
What providers will receive the increase?
Providers for all services on the Children's Long-Term Support (CLTS) Rate Schedule will receive the increase.
These services are:
- Adult family home placements
- Assistive technology/communication aids
- Child care for children ages 12 and above
- Community competitive/integrated employment: individual and small group (formerly called "supported employment: individual and small group")
- Community integration services
- Day services, children
- Daily living skills training
- Empowerment and self-determination supports (formerly called "consumer education and training")
- Financial management services
- Housing support services (formerly called "housing counseling")
- Mentoring
- Personal supports (formerly called "supportive home care (SHC)")
- Respite care
- Transportation services (excluding broker provided non-emergency transportation and ambulance services)
How does this affect provider billing and authorization?
Billing
The CLTS Rate Schedule and the Wisconsin Physicians Service (WPS) claims processing system will be updated on January 1, 2022, with the new rates. Providers should bill with the new rates for dates of service on or after January 1, 2022.
Authorizations
Authorizations for affected services entered or renewed by the county waiver agencies on or after January 1, 2022, will automatically reflect the new rates. Authorizations for dates of service after January 1, 2022, that were entered prior to that date will reflect the former rates. However, if providers bill the new rate, WPS will process the claim at the correct rate.
Resources
If you have any questions, please contact the WPS CLTS Contact Center at 877-298-1258.
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