Home and Community-Based Services for the Developmentally Disabled
The Home and Community-Based Services for the Developmentally Disabled (HCBS-DD) Waiver is administered by the California Department of Developmental Services (DDS) who will authorize home and community-based services for developmentally disabled persons who are Regional Center consumers. Twenty-one regional centers throughout California purchase and coordinate services and supports for individuals with developmental disabilities. The Waiver services make it possible for consumers to live in the community instead of an Intermediate Care Facility for the developmentally disabled or a State Developmental Center. The DD Waiver is currently the largest HCBS waiver in California as well as the nation.
For further information about this Waiver refer to
1915(c) Waivers page
The rate table linked below contains a list of reimbursement rates by procedure code that have been extracted from the current rates as of September 2021, in accordance with a State Plan Amendment. This table is for informational purposes only and may not reflect current reimbursement rates. For current rates, use the
Medi-Cal Rates page to access the current Medi-Cal rate table.
2023-2027 HCBS Renewal
On June 23, 2023, the Centers for Medicare & Medicaid Services (CMS) approved the renewal of the HCBS- DD Waiver. The waiver has been approved for a five-year period with a retroactive start date of January 1, 2023.
Current Waiver
Approved HCBS-DD Amendments
- HCBS-DD Waiver Amendment CA.0336.R05.10 (Effective January 1, 2025) this amendment is implementing the final round of rate increases from a 2019 rate study, adding a new service called Person-Centered Future Planning, increasing the rate for Financial Management Services, and allowing participant-direction for Community Living Arrangement Services.
- HCBS-DD Waiver Amendment CA .0336.R05.05 (Effective July 1, 2024) this amendment adds telehealth as a delivery method for specified services, adds group homes for children with special health care needs as a new provider of community living arrangement services, and adds participant-directed as a service delivery method for self-directed support services.
- Provisional Eligibility, Participant Directed Services, CIE Incentive Payments (Effective January 10, 20 24) this amendment adds the definition of the target population to include children under 5, participant-directed services as a new service, and additional incentive payments for assisting individuals to obtain competitive integrated employment.
- Coordinated Family Supports Amendment (Effective December 1, 202 3 ) this amendment adds the new service of Coordinated Family Supports (CFS), a service for adults to continue living in the family home, navigating existing services and supports.
Approved Emergency Amendments
- Approved Appendix K Santa Cruz Coastal Storm (Effective December 3, 2024 through January 23, 2025), in response to Santa Cruz county's coastal storm that occurred in December 2024, with extreme waves, storm surges, and high tides, resulting in coastal flooding, wave impacts, and damages along the coastline. This Appendix K allows the state to expand settings in which services may be provided and to authorize retainer payments for the following services:
- Habilitation – Community Living Arrangement Services
- Behavioral Intervention Services
- Day Services
- Approved Appendix K Palisades Fire (Effective January 7, 2025), in response to the Los Angeles and Ventura Counties Fire, which has burned over 70,000 acres, prompted evacuation orders and road closures, and continues to threaten structures, homes, and critical infrastructure. This amendment provides absence billing directive and expands the settings in which services can be provided during the State of Emergency.
- DHCS obtained approval for flexibilities accepted under the federal 1135 waiver authority which will expire January 7, 2026, for Los Angeles and Ventura Counties. The following flexibilities are available immediately.
- Permit evacuating facilities (such as ICF-DDs, SNFs) to be fully reimbursed for services rendered to affected beneficiaries in alternative physical settings, such as temporary shelters or other care facilities.
- Permit some services to continue to be provided without a requirement for a new or renewed prior authorization.
- Temporarily allow services to be provided in settings that have not been determined to meet the HCBS Settings Rule criteria.
- Temporarily extend the timeframe to reinstate services and benefits to an individual who files a fair hearing request.
- Approved Appendix K Northern California Earthquake (Effective December 5, 2024) California's Governor declared a State of Emergency in Del Norte, Humboldt, and Mendocino Counties in response to a magnitude 7.0 earthquake that occurred off the Northen California coastline near the city of Ferndale. It is anticipated that approximately 2,500 waiver participants may be impacted, either directly or indirectly by the earthquake. Regional Centers are assigned private agencies that are responsible for coordinating services for waiver consumers in the affected areas that impacted both consumers and providers. The purpose of this Appendix K is for absence billing directive during a State of Emergency.
- Several Appendix Ks have been approved in response to state emergency fires declared by the Governor. The first Appendix K – Pier Fire (Effective April 25, 2024), addresses the fire in the city of Oceanside, in San Diego County. The second Appendix K – Shelly Fire (Effective July 3, 2024), is in response to a fire that impacted waiver participants in Siskiyou County. The third Appendix K – Bear Fire (Effective September 2, 2024), is in response to a fire in Sierra County. Finally, the fourth Appendix K – Mountain Fire (Effective November 6, 2024), is in response to a fire in Ventura County.
- Approved Appendix K Lake County (Effective September 29, 2024) in response to the Boyles Fire, which has prompted evacuation orders for thousands of residents, threatening structures, homes, and critical infrastructure, ultimately damaging or destroying over 30 structures. It is anticipated that approximately 1,700 waiver participants may be impacted, either directly or indirectly by the fire. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K Los Angeles County and San Bernardino County Bridge Fire and Orange County and Riverside County Airport Fire (Effective September 11, 2024), in response to the Bridge and Airport Fires, which together have burned over 70,000 acres, and has prompted evacuation orders for thousands and continues to threaten homes, structures, and critical infrastructure. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K San Bernardino County Line Fire (Effective September 5, 2024), in response to the Line Fire, which has burned over 7,000 acres, prompted evaluation orders and road closures, and continues to threaten structures, homes, and critical infrastructure. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K Rancho Palos Verdes, Los Angeles County Land Movement (Effective September 3, 2024), in response to the accelerated land movement, which has accelerated significantly following the 2023 and 2024 severe storm events. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K Park and Gold Complex Fire, July 2024 (Effective July 26, 2024), in response to the State of Emergency in Plumas County, Butte County, and Tehama County in response to the Gold Complex and Park Fires, which have burned more than 300,000 acres, prompted evacuation orders for thousands and threatened homes, structures, critical infrastructure, transportation, communication sites, and transmission lines. Continued high temperatures, dry conditions and strong wind have increased the intensity and spread of the fires, causing imminent threat to life. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K Borel Fire, July 2024 (Effective July 30, 2024), in response to the State of Emergency in Kern County in response to the Borel Fire, which has burned more than 80,000 acres, and prompted evacuation orders and threatened homes, structures, and critical infrastructure. This amendment provides absence billing directive during a State of Emergency.
- Approved Appendix K Thompson Fire, July 2024 (Effective July 2, 2024, in response to the State of Emergency in Butte County in response to the Thompson Fire, which has burned approximately 4,000 acres and forced the evacuations of thousands of residents. This amendment provides absence billing directive during a State of Emergency.)
For previously Approved Appendix K documents visit this DHCS Waivers and Request Approvals page.
Withdrawn Waiver Amendments
HCBS-DD Waiver Amendment CA.0336.R05.06 proposed to implement the next round of rate increases associated with Rate Reform on July 1, 2024. Subsequent to the submission of this amendment to the Centers for Medicare and Medicaid Services (CMS), the 2024 California State Budget Agreement was announced, which included a revised implementation date of these increases of January 1, 2025. In response to this new date, CA.0336.R05.06 has been withdrawn from CMS review and the state will submit a new amendment, inclusive of the January 1, 2025, rate increases, at a later date.
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