November 4, 2021
Dear Community Day Services (CDS) Providers:
With the implementation of some of the components of the Guidehouse recommended rate methodology and rates for Community Day Services (CDS) effective January 1, 2022 (or pending final Centers for Medicare and Medicaid Services approval (CMS)) rates and billing processes will be changing.
While an Information Bulletin is forthcoming, we are excited to share that effective January 1, 2022 (or final approval from CMS) CDS providers will be able to bill up to 5 hours per day and 1200 hours per year based on individual attendance and/or HBS service agreements (up from 1100 hours/year). The new rates for services will be as follows:
Community Day Services - On-Site (31U): $14.33
Community Day Services - Off-Site (31C): $15.96
A new rate table will be posted in the coming days. The new rates reflect an average DSP wage of $16.00/hour and include employee related expenses (ERE) at 29.9%, administrative costs at 18.9% and program support at 10.6%. It also includes calculations for staff productivity, occupancy, transportation and capital. The new rates do not reflect the Guidehouse recommendations of an additional $.50 towards DSP wages or the regionalization factor of average wage rates as there was not appropriation to implement. You can find the full Guidehouse Rate Study here.
Additional changes of note:
* With the implementation of the new rates the temporary COVID-19 15% hourly increase will end.
* With the implementation of the new rates CDS providers will no longer bill for the training of their CDS staff (separately) as these training costs are built into the Guidehouse Rate Methodology under Program Support. Note: training will still be allowable for CILA providers as we are not fully adopting the Guidehouse rate methodology for CILA services as part of this waiver amendment.
- Day service billing for individuals from State Operated Developmental Center and Intermediate Care Facility for I/DD billing will shift to hourly (15-minute increment) billing to be consistent with waiver funded billing and to align with the Guidehouse Rate Study. Implementation will occur based on ability to program the new rates in the current billing systems. More details and billing codes are forthcoming in the Information Bulletin.
If you have any questions regarding CDS rates and billing, please feel free to reach out to Nikki Carnes . Please be on the lookout for the Information Bulletin with additional details.
We appreciate everything our CDS providers do each and every day! Thank you!
Director, Division of Developmental Disabilities