MedicaidReimbursementHigh impact
1915(c) HCBS Waiver Rate Increase Guidance
Kentucky Medicaid·KY·Reimbursement
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid is implementing rate increases for multiple 1915(c) HCBS waiver services effective January 1, 2025, requiring providers to update person-centered service plans and use corrected billing codes. Key changes include unit conversions from hourly to 15-minute billing, service code updates, and higher reimbursement rates for participant-directed services.
Action Required
By January 1, 2025: Billing teams must update person-centered service plans in MWMA system for affected waiver participants. End-date current service lines with 12/31/24 and add new service lines starting 1/1/25. Use corrected code T1016 or 590 (not T2016) for Conflict Free Case Management in HCB waiver. Convert hourly units to 15-minute units for respite and skilled services. Update EVV systems with new unit structures and override rates as needed. Failure to update service plans will prevent billing at new higher rates.