1915(c) Home and Community-Based Services Waivers
Home and Community-Based Services (HCBS) Waivers allow states that participate in Medicaid, known as Medi-Cal in California, to develop creative alternatives for individuals who would otherwise require care in a nursing facility or hospital. Medi-Cal has an agreement with the Federal Government, which allows for waiver services to be offered in either a home or community setting. The services offered under the waiver must cost no more than the alternative institutional level of care. Recipients of HCBS Waivers must have full-scope Medi-Cal eligibility.
What Services are Offered under HCBS Waivers?
The services available under HCBS Waivers include case management, community transition services, private duty nursing, family training, home health aides, life-sustaining utility reimbursement, habilitation services, respite care, and other services required to maintain the health and safety of eligible participants in the community setting of their choice.
- Assisted Living Waiver
- California Community Transitions Program
- Home and Community-Based Alternatives Waiver
- Medi-Cal Waiver Program
- Multipurpose Senior Services Program
Who Provides the Services?
There are a variety of HCBS Waiver providers, including but not limited to, the following:
- Licensed and certified Home Health Agencies;
- Individually licensed HCBS Waiver Providers; and/or
- Unlicensed caregivers.
HCBS Payment Rate Disclosure
42 CFR 447.203(b)(2)(iv) of the 2024 CMS Access Final Rule requires DHCS to develop and publish on its website a Payment Rate Disclosure for HCBS services. The Final Rule mandates that HCBS rates be published at the rate per hour. Where an hourly rate was not available, the increments of applicable codes were used to reflect an estimated hourly rate. For example, T2017 for Residential Habilitation is billed in 15-minute increments with a rate of $6.75. Therefore, an hourly rate of $27.00 is displayed.
This publication does not change or update any current reimbursement or billing policy and is for display purposes only in compliance with CMS regulations.
- DHCS HCBS Payment Rate Disclosure July 2026
- CADDS HCBS Payment Rate Disclosure July 2026
- CADSS HCBS Payment Rate Disclosure July 2026
How Long Can One Receive These Services?
The beneficiary may receive these home- and community-based services as long as they are medically necessary, cost-neutral, and he/she meets the nursing facility or acute hospital level of care.
How do I Become a HCBS Waiver Service Provider?
For information on becoming one of the following HCBS waiver providers or to request an application, please contact Provider Enrollment at (916) 552-9105. Email inquiries can be sent to: ProFacWAIVER@dhcs.ca.gov.
- HCBS Waiver Nurse Provider – RN and LVN (Individual Nurse Provider)
- INP Medi-Cal Checklist
- Home and Community-Based Services Nursing Facility (Congregate Living Health Facility)
- List of Congregate Living Health Facilities
- CLHF Medi-Cal Checklist
- List of Pediatric Day Health Centers
- Non-Profit Organization
- Personal Care Agency (PCA)
- Licensed Home Care Organizations (HCO) qualify to apply for the PCA provider type.
- PCA Medi-Cal Checklist
- Professional Corporation
- Public Subsidized Housing (PSH)
- PSH Initial Application
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