Intermediate Care Facilities – Developmentally Disabled, Habilitative and Nursing
Reimbursement rates for Intermediate Care Facilities, Developmentally Disabled (ICF/DD), Habilitative (ICF/DD-H), and Nursing (ICF/DD-N) are updated annually using an unfrozen, peer-grouped, cost-based rate methodology in accordance with Attachment 4.19-D of the California Medicaid State Plan. Facilities are classified into peer groups by level of care and bed size. The reimbursement rates for each peer group are established at the 65th percentile of the group’s projected costs based on the most recent reported and audited cost data adjusted for inflation, plus the projected cost of complying with new state or federal mandates (such as state minimum wage increases) and the Quality Assurance Fee (QAF). Effective August 1, 2022, the former Proposition 56 Supplemental Payments have transitioned to be included as part of the unfrozen, cost-based rate.
Hauv kev teb rau cov nqi nce ntxiv uas tshwm sim los ntawm cov tsev kho mob vim yog COVID-19 Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv Xwm Ceev (PHE), DHCS tau muab cov chaw no nrog COVID-19 PHE tus nqi ib ntus nce sib npaug li 10 feem pua ntawm lawv 2019-20 ib tus nqi tuag rau lub sijhawm ntawm PHE, raws li pom zoo hauv Xeev Txoj Kev Hloov Kho 20-0024.
Raws li Senate Bill 184 (Tshooj 47, Txoj Cai ntawm 2022), uas tau hloov kho Welfare thiab Institutions Code § 14105.075, DHCS tab tom tsim kom muaj kev tuav pov hwm tsis muaj teeb meem rau cov hnub ua haujlwm tom qab tau tshaj tawm qhov kawg ntawm PHE nyob rau hauv kev pom zoo Lub Xeev Txoj Kev Hloov Kho 22-0061. Qhov kev tuav pov hwm tsis muaj teeb meem yuav muab tau 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.
ICF/DD cov nyiaj them rov qab tau hloov ntawm lub Yim Hli mus rau Lub Xya Hli tus nqi xyoo ib xyoos rau ib xyoo raws li daim ntawv teev npe, pib txij lub Ib Hlis 1, 2024, raws li tau pom zoo hauv Xeev Txoj Kev Hloov Kho 23-0032.
Thov saib Daim Ntawv Qhia Tag Nrho hauv qab no rau qhov yuav tsum tau thov rau MCPs:
CY 2026 Tus nqi
CY 2026 Rate Study
Cov ntaub ntawv hauv qab no muaj cov qauv zaum kawg rau ICF-DD (H/N) CY 2026 tus nqi raws li California Medicaid State Plan (Ntawm 4.19-D).
CY 2026 Tus Nqi Txoj Cai Tsab Ntawv
ICF/DD Calendar Year 2026 Rates – Effective January 1, 2026 through December 31, 2026 (Published 10/31/2025)
Hom chaw |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
Total Reimbursement Per Diem |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
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:
- Rate table hloov kho raws li LTC Daim Ntawv Thov thiab Code Hloov.
- Xyoo 2026 Calendar 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.
ICF/DD Calendar Year 2025 Rates – Effective January 1, 2025 through December 31, 2025
Luam tawm 12/30/2024
Hom chaw |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
Total Reimbursement Per Diem |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
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:
- Rate table hloov kho raws li LTC Daim Ntawv Thov thiab Code Hloov.
- 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.
ICF/DD Calendar Year 2024 Rates – Effective February 1, 2024 through December 31, 2024
Hom chaw |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
Total Reimbursement Per Diem |
Tus nqi Code |
Tus nqi Code Tus nqi |
Cov nyiaj tau los Code |
Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 txaj |
24 |
41 | 0101 | $ 369.73 |
24 |
43 |
0180 | $ 360.21 |
| ICF/DD 60+ txaj |
24 |
42 | 0101 | $ 421.42 |
24 |
44 |
0180 | $ 411.90 |
| ICF/DD-H 4-6 txaj |
24 |
61 | 0101 |
$ 363.12 |
24 |
63 | 0180 | $ 353.60 |
| ICF/DD-H 7-15 txaj |
24 |
65 | 0101 |
$ 378.14 |
24 |
68 |
0180 |
$ 368.62 |
| ICF/DD-N 4-6 txaj |
24 |
62 |
0101 |
$ 394.48 |
24 |
64 |
0180 | $ 384.96 |
| ICF/DD-N 7-15 txaj |
24 |
66 | 0101 |
$ 445.65 |
24 |
69 | 0180 |
$ 436.13 |
Nco tseg:
- Rate table hloov kho raws li LTC Daim Ntawv Thov thiab Code Hloov.
- Xyoo 2024 Calendar Lub txaj tuav tus nqi yog $ 9.52.
- Managed Care cov koom haum yuav xa mus rau Total Reimbursement and the Total Bed Hold Reimbursement.
ICF/DD Calendar Year 2024 Rates – Effective January 1, 2024 through January 31, 2024
Hom chaw |
Regular Accommodation Code |
Total Reimbursement Per Diem |
Bed Hold Accommodation Code |
Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|
| ICF/DD 1-59 txaj |
41 |
$ 369.73 |
43 |
$ 360.21 |
| ICF/DD 60+ txaj |
41 |
$ 421.42 |
43 |
$ 411.90 |
| ICF/DD-H 4-6 txaj |
61 |
$ 363.12 |
63 |
$ 353.60 |
| ICF/DD-H 7-15 txaj |
65 |
$ 378.14 |
68 |
$ 368.62 |
| ICF/DD-N 4-6 txaj |
62 |
$ 394.48 |
64 |
$ 384.96 |
| ICF/DD-N 7-15 txaj |
66 |
$ 445.65 |
69 |
$ 436.13 |
Nco tseg:
- Xyoo 2024 Calendar Lub txaj tuav tus nqi yog $ 9.52.
- 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 ICF/DD tus nqi rau LTTCReimbursement@dhcs.ca.gov.