Kentucky Medicaid Waiver Rate Lookup
Find the Kentucky Medicaid fee schedule rate, procedure code, unit and service limit for 123 waiver services, then estimate monthly billing. Free, with no account and no email address.
Source and date
Rates are copied as published from the Kentucky Department for Medicaid Services (DMS) workbook Home and Community Based Services Waiver Rates 2025, retrieved on October 7, 2026. Check the DMS Fee and Rate Schedules page for the current file before you rely on a rate. One Care Portal is not affiliated with DMS, and this page is not a state service.
Direct answer: Per participant, per month: $425.92 under HCB (T1016 or 590), Michelle P. (T2022), SCL (T2022); $453.75 under ABI LTC (T2022); $525.14 under ABI Acute (T2022). These are the Kentucky DMS fee schedule rates effective January 1, 2025. Each is limited to one unit per participant per month.
Kentucky waiver case management rates
| Waiver | Service | Code | Rate |
|---|---|---|---|
| HCB | Conflict Free Case Management | T1016 or 590 | $425.92 per month |
| Michelle P. | Case Management | T2022 | $425.92 per month |
| SCL | Case Management | T2022 | $425.92 per month |
| ABI Acute | Case Management | T2022 | $525.14 per month |
| ABI LTC | Case Management | T2022 | $453.75 per month |
Billing calculator
Pick a service and enter how many participants you serve and how many units each receives in a month. Services paid up to a yearly or lifetime cap are left out.
Estimated billing at the fee schedule rate
$21,296.00 per month
$255,552.00 per year
50 participants × 1 unit × $425.92 (T1016 or 590, per month)
One Care Portal Case Management for the same caseload: $299.00 + $7.99 × 50 = $698.50 per month, month to month. See pricing.
This is arithmetic on the published rate. It is not a forecast of payment: prior authorization, service limits, the participant's plan and claim adjudication all affect what is paid. Nothing you type here is sent or stored.
Look up a rate
123 rates shown
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Home and Community Based (HCB)
16 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 7:010.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Adult Day Health Care - Level I | S5100 | 15-Minute | $3.82 | 200 units per week; cannot be billed concurrently with other services |
| Adult Day Health Care - Level II | S5100 U1 | 15-Minute | $4.15 | 200 units per week; cannot be billed concurrently with other services |
| Attendant Care - Traditional | S5108 or 580 | 15-Minute | $7.26 | 45 hours per week, alone or in combination with ADHC or $200 per day, alone or in combination with ADHC |
| Attendant Care - PDS | S5108 HI | 15-Minute | $7.26 | 45 hours per week, alone or in combination with ADHC or $200 per day, alone or in combination with ADHC |
| Conflict Free Case Management | T1016 or 590 | Per Month | $425.92 | One unit per participant, per month |
| Environmental and Minor Home Modifications | S5165 or 290 | Per Level of Care Year | Up to $3,025 | Up to $3,025 per level of care year |
| Financial Management | T2040 | Per Month | $196.63 | One unit per participant, per month |
| Goods and Services - Traditional | T1999 or 999 | Per Level of Care Year | Up to $4,235 | Up to $4,235 per level of care year |
| Goods and Services - PDS | T1999 HI | Per Year | Up to $4,235 | Up to $4,235 per level of care year |
| Home Delivered Meals | S5170 | Per Meal | $9.08 | Up to two meals per day, 10 meals per week |
| Non-Specialized Respite - Traditional | T1005 or 660 | 15-Minute | $5.92 | 42 units per day alone or in combination with Specialized Respite. Non-Specialized Respite alone or in combination with Specialized Respite shall not exceed 1000 units per year. |
| Non-Specialized Respite - PDS | T1005 HI | 15-Minute | $5.92 | 42 units per day alone or in combination with Specialized Respite. Non-Specialized Respite alone or in combination with Specialized Respite shall not exceed 1000 units per year. |
| Specialized Respite - Level I | T1005 or 662 | 15-Minute | $5.92 | 42 units per day alone or in combination with Non-Specialized Respite. Specialized Respite alone or in combination with Non-Specialized Respite shall not exceed 1000 units per year. |
| Specialized Respite - Level II | T1005 U1 or 660 | 15-Minute | $12.10 | 42 units per day alone or in combination with Non-Specialized Respite. Specialized Respite alone or in combination with Non-Specialized Respite shall not exceed 1000 units per year. |
| Specialized Respite - Level I (Congregate Setting) | T1005 U9 | 15-Minute | $5.92 | 42 units per day alone or in combination with Non-Specialized Respite. Specialized Respite alone or in combination with Non-Specialized Respite shall not exceed 1000 units per year. |
| Specialized Respite - Level II (Congregate Setting) | T1005 U1 U9 | 15-Minute | $12.10 | 42 units per day alone or in combination with Non-Specialized Respite. Specialized Respite alone or in combination with Non-Specialized Respite shall not exceed 1000 units per year. |
Michelle P. Waiver (MPW)
22 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 1:835.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Adult Day Health Care | S5100 | 15-minute | $3.82 | 160 units (40 hours) per week in combination with other services |
| Adult Day Training | T2021 | 15-minute | $3.62 | 160 units (40 hours) per week in combination with other services |
| Attendant Care - Traditional | S5125 | 15-minute | $6.36 | 160 units (40 hours) per week in combination with other services |
| Attendant Care - PDS | S5125 HI | 15-minute | $6.36 | 160 units (40 hours) per week in combination with other services |
| Behavioral Support Services | H0004 | 15-minute | $40.24 | 160 units (40 hours) per week in combination with other services |
| Case Management | T2022 | Per Month | $425.92 | One unit per participant, per month |
| Community Living Supports - Traditional | 97535 | 15-minute | $6.70 | 160 units (40 hours) per week in combination with other services |
| Community Living Supports - PDS | 97535 HI | 15-minute | $6.70 | 160 units (40 hours) per week in combination with other services |
| Environmental and Minor Home Adaptation | E1399 | Per Plan of Care | Up to $605 | Up to $605 per plan of care year |
| Financial Management Services | T2040 HI | Per Month | $121.00 | One unit per participant, per month |
| Homemaker - Traditional | S5130 | 15-minute | $7.87 | 160 units (40 hours) per week in combination with other services |
| Homemaker - PDS | S5130 HI | 15-minute | $7.87 | 160 units (40 hours) per week in combination with other services |
| Occupational Therapy | 97530 | 15-minute | $26.83 | 160 units (40 hours) per week in combination with other services |
| Personal Care - Traditional | T1019 | 15-minute | $9.08 | 160 units (40 hours) per week in combination with other services |
| Personal Care - PDS | T1019 HI | 15-minute | $9.08 | 160 units (40 hours) per week in combination with other services |
| Physical Therapy | 97110 | 15-minute | $26.83 | 160 units (40 hours) per week in combination with other services |
| Respite | T1005 | 15-minute | $5.92 | 1,312 units per plan of care year |
| Respite - Congregate Setting | T1005 U9 | 15-minute | $5.92 | 1,312 units per plan of care year |
| Respite - PDS | T1005 HI | 15-minute | $5.92 | 1,312 units per plan of care year |
| Speech Therapy | 92507 | 15-minute | $26.83 | 160 units (40 hours) per week in combination with other services |
| Supported Employment - Traditional | H0039 | 15-minute | $10.54 | 160 units (40 hours) per week in combination with other services |
| Supported Employment - PDS | H0039 HI | 15-minute | $10.54 | 160 units (40 hours) per week in combination with other services |
Supports for Community Living (SCL)
36 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 12:010.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Case Management | T2022 | Per Month | $425.92 | One unit per participant, per month |
| Community Access, Individual | 97535 | 15-minute | $10.65 | 16 hours per day alone or in combination with Day Training, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Community Access, Individual - PDS | 97535 HI | 15-minute | $10.65 | 16 hours per day alone or in combination with Day Training, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Community Access, Group | 97537 | 15-minute | $5.32 | 16 hours per day alone or in combination with Day Training, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Community Access, Group - PDS | 97537 HI | 15-minute | $5.32 | 16 hours per day alone or in combination with Day Training, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Community Guide | H2015 | 15-minute | $10.65 | 576 units per plan of care year |
| Community Guide - PDS | H2015 HI | 15-minute | $10.65 | 576 units per plan of care year |
| Community Transition | T2038 | Per Transition | Up to $2,420 | Up to $2,420 per transition |
| Consultative Clinical and Therapeutic Services (Behavioral) | H0004 U7 | 15-minute | $29.95 | 160 units per person-centered service plan year in combination with Consultative Clinical and Therapeutic Services - Dietary, Psychological, and/or Functional Analysis |
| Consultative Clinical and Therapeutic Services (Dietary) | H0004 UA | 15-minute | $29.95 | 160 units per person-centered service plan year in combination with Consultative Clinical and Therapeutic Services - Behavioral, Psychological, and/or Functional Analysis |
| Consultative Clinical and Therapeutic Services (Psychological) | H0004 HE | 15-minute | $29.95 | 160 units per person-centered service plan year in combination with Consultative Clinical and Therapeutic Services - Dietary, Behavioral, and/or Functional Analysis |
| Consultative Clinical and Therapeutic Services (Functional Analysis) | H0004 HK | 15-minute | $29.95 | 160 units per person-centered service plan year in combination with Consultative Clinical and Therapeutic Services - Dietary, Behavioral, and/or Psychological |
| Day Training | T2021 | 15-minute | $3.62 | 16 hours per day alone or in combination with Community Access, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Day Training at an ADHC | S5100 | 15-minute | $3.99 | 16 hours per day alone or in combination with Community Access, Personal Assistance, or any hours of paid community employment or on-site Supported Employment |
| Environmental Accessibility Adaptation Services - PDS | T2028 HI | Lifetime | Up to $9,680 | Up to $9,680 per lifetime |
| Financial Management Services | T2040 HI | Per Month | $121.00 | One unit per participant, per month |
| Goods and Services | T1999 | Per Plan of Care Year | Up to $2,178 | Up to $2,178 per person-centered service plan year |
| Goods and Service - PDS | T1999 HI | Per Plan of Care Year | Up to $2,178 | Up to $2,178 per person-centered service plan year |
| Natural Supports Training - PDS | T2025 HI | Per Plan of Care Year | Up to $1,210 | Up to $1,210 per person-centered service plan year |
| Person-Centered Coaching | H0023 | 15-minute | $7.66 | 1,320 units per year |
| Personal Assistance | T1019 | 15-minute | $7.37 | 16 hours per day alone or in combination with Community Access, Day Training, or any hours of paid community employment or on-site Supported Employment |
| Personal Assistance - PDS | T1019 HI | 15-minute | $7.37 | 16 hours per day alone or in combination with Community Access, Day Training, or any hours of paid community employment or on-site Supported Employment |
| Positive Behavior Support Plan | 96158 | Per Plan | $885.12 | — |
| Residential Support Level I - 3 residents or fewer | T2016 UP | Per Day | $284.57 | One unit per participant, per day |
| Residential Support Level I - 4 to 8 residents | T2016 US | Per Day | $215.09 | One unit per participant, per day |
| Residential Support Level II | S9976 | Per Day | $129.91 | One unit per participant, per day |
| Residential Support Level II - 12+ hours of supervision | T2016 | Per Day | $198.70 | One unit per participant, per day |
| Respite | T1005 | 15-minute | $5.92 | 3,320 units (830 hours) per person-centered service plan year |
| Respite - Congregate Setting | T1005 U9 | 15-minute | $5.92 | 3,320 units (830 hours) per person-centered service plan year |
| Respite - PDS | T1005 HI | 15-minute | $5.92 | 3,320 units (830 hours) per person-centered service plan year |
| Shared Living | T2032 HI | Per Month | $726.00 | One unit per participant, per month |
| Supported Employment | T2019 | 15-minute | $13.65 | 16 hours per day alone or in combination with Community Access, Day Training, or any hours of paid community employment For SCL Person Centered Job Selection funding, the participant may access up to 120 units For SCL Job Development Services, the participant and their employment specialist may access up to 90 units. For SCL Job Acquisition and Stabilization Services, the participant and their SE Specialist may access up to 800 units For SCL Long-Term Employment Supports, the participant and their SE Specialist may access up to twenty-four (24) units of SE per month |
| Supported Employment - PDS | T2019 HI | 15-minute | $13.65 | 16 hours per day alone or in combination with Community Access, Day Training, or any hours of paid community employment For SCL Person Centered Job Selection funding, the participant may access up to 120 units For SCL Job Development Services, the participant and their employment specialist may access up to 90 units. For SCL Job Acquisition and Stabilization Services, the participant and their SE Specialist may access up to 800 units For SCL Long-Term Employment Supports, the participant and their SE Specialist may access up to twenty-four (24) units of SE per month |
| Technology Assisted Residential | T2031 | Per Day | $105.15 | One unit per participant, per day |
| Transportation | T2003 HI | Per Month | $320.65 | $320.65 per participant, per month |
| Vehicle Adaptations | T2039 HI | Every Five Years | Up to $7,260 | Up to $7,260 per participant, every five years |
Acquired Brain Injury (ABI) Acute
22 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 3:090.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Adult Day Training | 97537 | 15-minute | $4.88 | 160 units per calendar week, alone or in combination with Supported Employment |
| Assessment & Reassessment | T1028 | Per Assessment | $121.00 | One unit at least every 12 months, or more often if indicated |
| Behavior Programming | H0004 | 15-minute | $40.67 | 16 units per day |
| Case Management | T2022 | Per Month | $525.14 | One unit per participant, per calendar month |
| Companion | S5135 | 15-minute | $6.73 | 200 units per week |
| Companion - PDS | S5135 HI | 15-minute | $6.73 | 200 units per week |
| Counseling, Individual | H2017 | 15-minute | $28.85 | 16 units per day |
| Counseling, Group | 90853 | 15-minute | $6.96 | 48 units per participant, per calendar month |
| Environmental or Minor Home Adaptation | S5165 | Per Plan of Care Year | Up to $2,420.00 | Up to $2,420.00 per participant, per plan of care year |
| Financial Management Services | T2040 HI | Per Month | $121.00 | One unit per participant, per calendar month |
| Occupational Therapy | 97530 | 15-minute | $31.34 | 16 units per day |
| Personal Care | 97535 | 15-minute | $6.73 | 80 units per week |
| Personal Care - PDS | 97535 HI | 15-minute | $6.73 | 80 units per week |
| Respite | T1005 | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Respite - Congregate Setting | T1005 U9 | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Respite - PDS | T1005 HI | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Speech Therapy | 92507 | 15-minute | $34.38 | 16 units per day |
| Supervised Residential Care - Level I | T2016 | Per Day | $300.00 | One unit per participant, per calendar day |
| Supervised Residential Care - Level II | T2033 | Per Day | $225.00 | One unit per participant, per calendar day |
| Supervised Residential Care - Level III | S5136 | Per Day | $112.50 | One unit per participant, per calendar day |
| Supported Employment | H0039 | 15-minute | $10.54 | 160 units per calendar week, alone or in combination with Adult Day Training |
| Supported Employment - PDS | H0039 HI | 15-minute | $10.54 | 160 units per calendar week, alone or in combination with Adult Day Training |
Acquired Brain Injury Long Term Care (ABI LTC)
24 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 3:210.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Adult Day Health Care | S5100 | 15-minute | $3.86 | 160 units per calendar week |
| Adult Day Training | T2021 | 15-minute | $4.88 | 160 units per calendar week, alone or in combination with Supported Employment |
| Assessment & Reassessment | T1028 | Per Assessment | $121.00 | One unit at least every 12 months, or more often if indicated |
| Behavior Programming Services | H0004 | 15-minute | $40.67 | 80 units per month for the first three months of waiver participation, thereafter not to exceed 48 units per month. |
| Case Management | T2022 | Per Month | $453.75 | One unit per participant, per calendar month |
| Community Living Supports | 97535 | 15-minute | $6.73 | 160 units per week |
| Community Living Supports - PDS | 97535 HI | 15-minute | $6.73 | 160 units per week |
| Counseling, Individual | H2017 | 15-minute | $28.85 | 52 units per participant, per month |
| Counseling, Group | 90853 | 15-minute | $6.96 | 48 units per participant, per month |
| Environmental and Minor Home Modifications | T2029 | Per Plan of Care Year | Up to $2,420.00 | Up to $2,420.00 per participant, per plan of care year |
| Family Training | 97537 | 15-minute | $30.25 | Eight units per week |
| Financial Management Services | T2040 HI | Per month | $121.00 | One unit per participant, per calendar month |
| Nursing Supports | T1004 | 15-minute | $30.25 | 28 units per week |
| Occupational Therapy | 97530 | 15-minute | $31.34 | 52 units per month |
| Physical Therapy | 97110 | 15-minute | $30.25 | 52 units per month |
| Respite | T1005 | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Respite - Congregate Setting | T1005 U9 | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Respite - PDS | T1005 HI | 15-minute | $5.92 | 5,760 units per participant, per plan of care year |
| Speech Therapy | 92507 | 15-minute | $34.38 | 52 units per month |
| Supervised Residential Care - Level I | T2016 | Per Day | $300.00 | One unit per participant, per calendar day |
| Supervised Residential Care - Level II | T2033 | Per Day | $225.00 | One unit per participant, per calendar day |
| Supervised Residential Care - Level III | S5136 | Per Day | $112.50 | One unit per participant, per calendar day |
| Supported Employment | H0039 | 15-minute | $10.54 | 160 units per calendar week, alone or in combination with Adult Day Training |
| Supported Employment - PDS | H0039 HI | 15-minute | $10.54 | 160 units per calendar week, alone or in combination with Adult Day Training |
Model II Waiver (MIIW)
3 services. Rates effective January 1, 2025; DMS schedule last updated January 2, 2025. Program rules: 907 KAR 1:595.
| Service | Code | Unit | Rate | Service limit |
|---|---|---|---|---|
| Skilled Services by an LPN | 559 | 15-minute | $11.58 | 64 units (16 hours) per day |
| Skilled Services by an RN | 552 | 15-minute | $15.99 | 64 units (16 hours) per day |
| Skilled Services by an RT | 410 | 15-minute | $13.36 | 64 units (16 hours) per day |
Reading the schedule
- Unit. Most direct services are paid per 15-minute unit. Case management is paid per month, and residential services per day.
- Service limit. The limit column is DMS's wording. Limits apply per participant and often combine several services.
- Caps. Rows shown as "Up to" an amount are yearly, per-plan or lifetime caps, not per-unit rates.
- Attested rates. DMS's 1915(c) services summary lists higher attested rates for some direct services. This lookup shows the base rates only.
- Not included. The DMS workbook also has a CHILD waiver sheet with rates effective January 1, 2026. It is not in this lookup yet.
Where One Care Portal fits
This lookup is a free reference and is separate from the product. Kentucky Michelle P., SCL, HCB and ABI/ABI-LTC case management agencies can use One Care Portal for caseloads, visit schedules, contact notes and supervisor review. Each service authorization record holds the procedure code, dates, authorized units and rate, so the note and the authorization sit together when it is time to bill.
Important boundary: One Care Portal does not connect to MWMA, and direct KYMMIS claim submission is not assumed. It is not certified, endorsed or approved by Kentucky. Each agency's forms, permissions, reporting, authorizations and billing route are confirmed before implementation.
Want to see the software? Only if it helps.
The lookup stays free either way. If you run case management under a Kentucky waiver and want to see caseloads, contact notes and authorizations in one place, book a 30-minute demo. Pricing is a $299/month platform fee plus $7.99 per active participant, month to month.
Do not submit participant names, records, service details, or other PHI through the booking form.
Frequently asked questions
How much does Kentucky Medicaid pay for waiver case management?
Per participant, per month: $425.92 under HCB (T1016 or 590), Michelle P. (T2022), SCL (T2022); $453.75 under ABI LTC (T2022); $525.14 under ABI Acute (T2022). These are the Kentucky DMS fee schedule rates effective January 1, 2025. Each is limited to one unit per participant per month.
Where do these Kentucky waiver rates come from?
From the Kentucky Department for Medicaid Services workbook "Home and Community Based Services Waiver Rates 2025", published on the DMS Fee and Rate Schedules page and retrieved on October 7, 2026. One Care Portal copies the rates as published and is not affiliated with DMS.
Are these the rates my agency will be paid?
They are the base fee schedule rates. What an agency is paid also depends on prior authorization, service limits, the participant's plan, and claim adjudication, and DMS lists higher attested rates for some direct services. Confirm current rates with Kentucky DMS before relying on them.
Is the Kentucky waiver rate lookup free?
Yes. It is free, needs no account or email address, and has nothing to buy. One Care Portal publishes it for Kentucky waiver providers; booking a software demo is optional.