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Intermediate Care Facilities 

Developmentally Disabled (ICF/DD) | Habilitative (ICF/DD-H) | Nursing (ICF/DD-N)

These facilities are peer grouped by level of care and bed size and are reimbursed at the 2008-09 65th percentile established for the facility’s respective peer group increased by 3.7 percent, through the enabling legislation of Assembly Bill (AB) x21, and Welfare and Institutions Code Section 14105.075.  The reimbursement rate will also include the projected cost of complying with any new State or federal mandates to the extent applicable to the reimbursement methodology associated with the type of facility.

 

2017.18 Comprehensive Rate List

Below is a comprehensive LTC rate list of the 2017-18 Final Rate, Supplemental Per Diem, and the total LTC reimbursement rates. The 2017-18 Final Rate includes the 3.7 percent rate increase, applicable add-ons, and the Quality Assurance Fee. 
Providers should continue to bill the 2017-18 Final Rate in accordance with the Medi-Cal Provider Manual. The respective peer group supplemental payment amount will be automatically added to the claim payment by our Fiscal Intermediary, Conduent State Healthcare, LLC, for every claim that is billed for dates of service August 1, 2017 through July 31, 2018.

2017.18 Intermediate Care Facilities Supplemental Payment Per Diem Amounts

ICF/DD Supplemental Payment Per Diem Amounts
 
Facility
Peer Group
LTC Accommodation Code
(Regular Services)
Bedhold Accommodation Code
Supplemental Payment Per Diem
ICF/DD
 41 (1-59 beds)
43
$15.47
ICF/DD
 41 (60+ beds)
43
$0.00
ICF/DD-H
 61 (4-6 beds)
63
$10.75
ICF/DD-H
 65 (7-15 beds)
68
$0.00
ICF/DD-N
 62 (4-6 beds)
64
$12.47
ICF/DD-N
 66 (7-15 beds)
69
$22.30
  Note that facilities in peer groups in which the unfrozen 2017-18 65th percentile rate is lower than the current reimbursement rate will not receive the supplemental payment.   

2017.18 Intermediate Care Facilities Amended Rates

The Department amended the 2017-18 reimbursement rates effective for dates of service on or after August 1, 2017. 

The reimbursement rates were amended due to an adjustment to the Affordable Care Act (ACA) Employer Shared Responsibility add-on amount. These rates supersede the original rates below and are only for the facilities that submitted a certification form.   

2017.18 Intermediate Care Facilities Rates 

The Department updated the 2017-18 reimbursement rates effective for dates of service on or after August 1, 2017. 

The following rates are for all facilities by peer group and are the rates for the facilities that did not submit a certification form.  

 

The following rates include the additional facility-specific add-on related to the ACA Employer Shared Responsibility Mandate and the ACA IRS Employer Reporting Mandate.  These rates are only for the facilities that submitted either or both the ACA Mandate forms.   

 2016.17 Intermediate Care Facility Rates

The Centers for Medicare and Medicaid Services (CMS) approved a new reimbursement methodology for ICF/DD, ICF/DD-H, and ICF/DD-N effective August 1, 2016, pursuant to State Plan Amendment 16-012.  The new methodology authorizes the Department of Health Care Services (DHCS) to reimburse facilities at the 2008-09 65th percentile established for the facility’s respective peer group increased by 3.7 percent, through the enabling legislation of Assembly Bill (AB) x21, and Welfare and Institutions Code Section 14105.075.  The reimbursement rate will also include the projected cost of complying with any new State or federal mandates to the extent applicable to the reimbursement methodology associated with the type of facility.

  

The following rates are for all facilities by peer group and are the rates for the facilities that did not submit a certification form. 

 

 The following rates include the additional facility-specific add-on related to the ACA Employer Shared Responsibility Mandate and the ACA IRS Employer Reporting Mandate.  These rates are only for the facilities that submitted either or both the ACA Mandate forms. 
 

2015.16 Intermediate Care Facility Rates

The Department updated the 2015-16 reimbursement rates effective for dates of service on or after August 1, 2015.  The rates were implemented in the system in October 2015.   

2014.15 Intermediate Care Facility Rates

The Department updated the Final 2014-15 reimbursement rates effective for dates of service on or after August 1, 2014.  The rates, implemented on June 22, 2015, will supersede the interim 2014-15 reimbursement rates that were previously implemented on October 20, 2014.   

  

Note: The Department established interim reimbursement rates by updating the 2013-2014 rates, implemented on 5/27/14, to include the mandatory 2014 minimum wage add-ons.  The interim rates will be effective for dates of service on or after August 1, 2014, and will be subject to change upon implementation of the final 2014-15 rates.  Xerox estimates the 2014-2015 interim rates will be implemented in the system on October 20, 2014.
 
All documents are PDF.

2013.14 Intermediate Care Facility Rates - Updated 9/19/2014 

2012.13 Intermediate  Care Facility Rates

Note:  The reimbursement rates for 2012/13, effective August 1, 2012, will not be implemented.  Providers will continue to be paid a reimbursement rate currently on file (established in the 2011/12 rate year) until the 2013/14 rates are implemented on May 27, 2014.

Previous Intermediate Care Facility Rates

 

Return to Long Term Care Reimbursement Index

Last modified on: 5/30/2018 12:25 PM