Minimum Fee Schedule for Home and Community-Based Services

The Wisconsin Department of Health Services (DHS) has created a minimum fee schedule for adult home and community-based services (HCBS). The schedule is a list of the lowest rates managed care organizations (MCO) can pay providers of certain adult long-term care services in Family Care, Family Care Partnership, and the Program of All-Inclusive Care for the Elderly (PACE). It applies to:

• Supportive home care services:
  • Agency
  • Member self-directed
• Residential facilities:
  • 1–2 bed adult family homes (AFHs)—owner occupied and corporate owned
  • 3–4 bed AFHs
  • Residential care apartment complexes (RCACs)
  • Community-based residential facilities (CBRFs)

MCOs must follow the minimum fee schedule beginning October 1, 2024. MCOs will continue to be contractually required to negotiate rates and pay above the minimum when needed to get members the care they need. DHS will monitor MCOs to ensure they are paying providers at or above the minimums. MCOs will take on contractual penalties if they fail to pay the minimums.

Minimum fee schedule effective October 1, 2024

DHS estimates an average 15% rate increase for most supportive home care services and an average 40.5% rate increase for most services provided at residential facilities, among other rate increases. The actual change for each provider depends on their current contracts with MCOs and how much their rate would need to increase, if at all, to be paid at the minimum fee schedule.

Related resources

• Frequently Asked Questions (last updated November 19, 2024) New
• HCBS Minimum Fee Schedule Webinar Recording (held September 13, 2024)
• HCBS Minimum Fee Schedule Webinar PowerPoint slides
• Self-Directed Services Home and Community-Based Services Minimum Fee Rate Agreement, F-03303: Caregivers who want to receive less than the minimum fee schedule amount can fill out this form.
• New Provider Enrollment System for Adult Long-Term Care: Most adult long-term care waiver services providers will soon need to enroll with Wisconsin Medicaid using the ForwardHealth Portal.