Cov Chaw Saib Xyuas Qib Nruab Nrab - Cov Neeg Muaj Kev Tsis Taus Hauv Kev Loj Hlob, Cov Neeg Uas Muaj Kev Xav Tau Kev Pab thiab Cov Neeg Saib Xyuas Neeg Mob
Cov nqi them rov qab rau Cov Chaw Saib Xyuas Qib Nruab Nrab, Cov Neeg Muaj Kev Tsis Taus Hauv Kev Loj Hlob (ICF/DD), Cov Neeg Muaj Peev Xwm Nyob Tau (ICF/DD-H), thiab Cov Neeg Saib Xyuas Neeg Mob (ICF/DD-N) raug hloov kho txhua xyoo siv txoj kev ntsuas tus nqi uas tsis tau khov, sib koom ua ke, thiab raws li tus nqi raws li Daim Ntawv Ntxiv 4.19-D ntawm California Medicaid State Plan. Cov chaw kho mob raug muab faib ua pawg raws li qib kev saib xyuas thiab qhov loj ntawm lub txaj. Cov nqi them rov qab rau txhua pawg neeg sib npaug yog tsim los ntawm 65th feem pua ntawm cov nqi kwv yees ntawm pawg neeg raws li cov ntaub ntawv nqi tshaj tawm tshiab tshaj plaws thiab tau tshuaj xyuas kho rau kev nce nqi, ntxiv rau tus nqi kwv yees ntawm kev ua raws li lub xeev lossis tsoomfwv cov lus txib tshiab (xws li kev nce nyiaj hli tsawg kawg nkaus ntawm lub xeev) thiab Tus Nqi Kev Ntsuam Xyuas Zoo (QAF). Txij li Lub Yim Hli 1, 2022, cov Kev Them Nyiaj Ntxiv ntawm Proposition 56 yav dhau los tau hloov pauv mus rau suav nrog ua ib feem ntawm tus nqi tsis khov, raws li tus nqi.
Vim yog COVID-19 Kev Noj Qab Haus Huv Pej Xeem (PHE) ua rau muaj kev nyuaj siab rau cov nqi kho mob uas cov chaw kho mob tau them vim muaj COVID-19 PHE, DHCS tau muab cov chaw kho mob no nrog kev nce tus nqi ib ntus rau COVID-19 PHE sib npaug li 10 feem pua ntawm lawv cov nqi them txhua hnub xyoo 2019-20 rau lub sijhawm ntawm PHE, raws li tau pom zoo hauv Txoj Kev Npaj Hloov Kho Xeev 20-0024.
Raws li Senate Bill 184 (Tshooj 47, Statutes of 2022), uas tau hloov kho Welfare and Institutions Code § 14105.075, DHCS tab tom tsim kom muaj kev txwv tsis pub siv rau hnub tim ntawm kev pabcuam tom qab qhov kawg ntawm PHE hauv Txoj Cai Hloov Kho Txoj Kev Npaj Hauv Xeev 22-0061 uas tau pom zoo. Cov kev cai txwv tsis pub ua txhaum cai yuav qhia tias tom qab hnub kawg ntawm PHE, cov chaw yuav tau txais ntau dua ntawm:
- Tus nqi tsis khov, tus nqi raws li tau piav qhia saum toj no, lossis
- Tag nrho cov nyiaj them rov qab tau siv rau hnub kawg ntawm PHE, suav nrog COVID-19 PHE tus nqi nce ib ntus.
Kev them rov qab ICF/DD tau hloov ntawm lub Yim Hli mus rau Lub Xya Hli tus nqi txhua xyoo mus rau lub xyoo tus nqi txhua xyoo, siv tau rau Lub Ib Hlis 1, 2024, raws li tau pom zoo hauv Txoj Cai Hloov Kho Txoj Kev Npaj ntawm Lub Xeev 23-0032.
Thov saib tsab ntawv qhia txog Kev Npaj Txhua Yam hauv qab no rau cov kev cai uas siv rau MCPs:
- APL 26-012 Cov Chaw Saib Xyuas Qib Nruab Nrab Rau Cov Neeg Uas Muaj Kev Tsis Taus Hauv Kev Loj Hlob - Kev Pab Saib Xyuas Mus Ntev Hauv Kev Tswj Xyuas Kev Saib Xyuas (Hloov APL 24-011)
Tus Nqi Xyoo 2027
Kev Tshawb Fawb Txog Tus Nqi CY 2027
The document below contains the finalized model for ICF-DD (H/N) CY 2027 rates in accordance with California Medicaid State Plan (Attachment 4.19-D).
- CY 2027 ICF-DD Final Rate Study (Updated 10/30/2026)
CY 2027 Rates Policy Letter
ICF/DD Calendar Year 2027 Rates – Effective January 1, 2027 through December 31, 2027
Published 10/30/2026
| Hom chaw | Tus nqi Code | Tus nqi Code Tus nqi | Revenue Code | Total Reimbursement | Tus nqi Code | Tus nqi Code Tus nqi | Revenue Code | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 433.48 | 24 | 43 | 0180 | $ 423.03 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 410.97 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 497.26 | 24 | 63 | 0180 | $ 486.81 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 491.07 | 24 | 68 | 0180 | $ 480.62 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 524.08 | 24 | 64 | 0180 | $ 513.63 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 564.38 | 24 | 69 | 0180 | $ 553.93 |
Nco tseg:
- Rate table updated in accordance with the LTC Claim Form and Code Conversion.
- The 2027 Calendar Year bed hold amount is $10.45.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tus Nqi Xyoo 2026 ntawm ICF/DD - Siv Tau Txij Lub Ib Hlis 1, 2026 txog Lub Kaum Ob Hlis 31, 2026 (Luam tawm thaum 10/31/2025)
| Hom chaw | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Reimbursement Per Diem | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 433.48 | 24 | 43 | 0180 | $ 423.53 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 411.47 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 424.66 | 24 | 63 | 0180 | $ 414.71 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 430.91 | 24 | 68 | 0180 | $ 420.96 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 451.20 | 24 | 64 | 0180 | $ 441.25 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 485.42 | 24 | 69 | 0180 | $ 475.47 |
Nco tseg:
- Daim ntawv teev nqi tau hloov kho tshiab raws li Daim Ntawv Thov LTC thiab Kev Hloov Kho Code.
- 2026 Daim Ntawv Qhia Xyoo Lub txaj tuav tus nqi yog $ 9.95.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tus Nqi Xyoo 2025 ntawm ICF/DD - Siv tau rau lub Ib Hlis 1, 2025 txog rau lub Kaum Ob Hlis 31, 2025
Luam tawm 12/30/2024
| Hom chaw | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Reimbursement Per Diem | Tus nqi Code | Tus nqi Tus lej Tus nqi | Cov lej nyiaj tau los | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj | 24 | 41 | 0101 | $ 383.31 | 24 | 43 | 0180 | $ 373.54 |
| ICF/DD 60+ txaj | 24 | 42 | 0101 | $ 421.42 | 24 | 44 | 0180 | $ 411.65 |
| ICF/DD-H 4-6 txaj | 24 | 61 | 0101 | $ 403.44 | 24 | 63 | 0180 | $ 393.67 |
| ICF/DD-H 7-15 txaj | 24 | 65 | 0101 | $ 392.18 | 24 | 68 | 0180 | $ 382.41 |
| ICF/DD-N 4-6 txaj | 24 | 62 | 0101 | $ 424.05 | 24 | 64 | 0180 | $ 414.28 |
| ICF/DD-N 7-15 txaj | 24 | 66 | 0101 | $ 477.62 | 24 | 69 | 0180 | $ 467.85 |
Nco tseg:
- Daim ntawv teev nqi tau hloov kho tshiab raws li Daim Ntawv Thov LTC thiab Kev Hloov Kho Code.
- Xyoo 2025 Calendar Lub txaj tuav tus nqi yog $ 9.77.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
Tiv tauj peb
Thov xa cov lus nug txog cov nqi ICF/DD mus rau LTCReimbursement@dhcs.ca.gov.