MedicaidReimbursementMedium impact
1915(c) HCBS Waiver Respite Guidance
Kentucky Medicaid·KY·Provider Letter
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Kentucky's 1915(c) Home and Community Based Services waivers changed respite billing from cost-based to unit-based effective January 1, 2025. Michelle P. Waiver respite is now billed at $5.92 per 15-minute unit with a 1,312 unit annual limit, while HCB waiver respite has a 42 unit daily limit and 1,000 unit annual limit.
Action Required
Immediately for 2025 claims: Update billing systems to bill Michelle P. Waiver respite services at $5.92 per 15-minute unit instead of cost-based billing. Verify participant eligibility limits - MPW participants limited to 1,312 units annually, HCB waiver participants limited to 42 units daily and 1,000 units annually. Case managers must modify Person-Centered Service Plans before participants use respite services in 2025.