These facilities are peer grouped by level of care and bed size. Beginning with the 2013/14 rates, effective for dates of service on or after
May 27, 2014, ICF/DD, ICF/DD-H, and ICF/DD-N providers will be reimbursed at the facilities’ rebased projected cost per day plus 5 percent, but no higher than the 65th percentile rate established in 2008-09, and no lower than the 65th percentile rate established in 2008-09, reduced by 10 percent. DHCS will determine each facility’s rebased projected cost by using cost or audited cost reports each year.
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