This compendium summarizes state Medicaid payment policies for home- and community-based services (HCBS) provided under the waiver authority of Section 1915(c) of the Social Security Act. The compendium also describes other authorities that states use to cover HCBS, such as state plan options and Section 1115 demonstration waivers, but payment methodologies for those authorities were not readily available.
The analysis focuses on rate methodologies applicable to three primary service categories within the HCBS taxonomy—home-based services, day services, and round-the-clock care. The HCBS taxonomy, comprising 18 service categories, was developed to uniformly classify state-defined services, offering a structured framework for understanding the diverse array of HCBS benefits. In the course of our review, researchers identified 253 unique services, as defined by individual states, that fall within the three taxonomy categories.
In addition to the Excel spreadsheet, find a summary of key findings from this analysis available in an accompanying policy brief here.