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Intermediate Care Facilities 

Developmentally Disabled (ICF/DD) | Habilitative (ICF/DD-H) | Nursing (ICF/DD-N)

These facilities are peer grouped by level of care and bed size and are reimbursed 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. 

2018.19 Intermediate Care Facilities Amended Rates

The Department amended the 2018-19 reimbursement rates effective for dates of service on or after August 1, 2018, due to revisions made to the Minimum Wage add-on. Providers will continue to receive the initial 2018-19 reimbursement rates until the 2018-19 amended reimbursement rates are implemented in the system. Once the amended reimbursement rates are implemented, the Department will issue payments retroactive to August 1, 2018.

The following is a comprehensive list of the 2018-19 Amended Rates including the supplemental payment per diem, and the total reimbursement rates for all ICFDDs peer groups. The 2018-19 amended rates include the 3.7 percent rate increase, applicable add-ons, and the Quality Assurance Fee (QAF). The respective peer group supplemental payment amount will be automatically added to the claim payment by our Fiscal Intermediary, Conduent State Healthcare, LLC, for every claim that is billed for dates of service August 1, 2018 through July 31, 2019.

The following amended rates are for all facilities by peer group and are the rates for the facilities that did not submit a certification form.

 

The following amended rates include the additional facility-specific add-on related to the ACA Employer Shared Responsibility Mandate and the ACA IRS Employer Reporting Mandate.  These amended rates are only for the facilities that submitted either or both the ACA Mandate forms.

2018.19 Intermediate Care Facilities Supplemental Payment Per Diem Amounts

 ICF/DD Supplemental Payment Per Diem Amounts
 
Facility
Peer Group
ICF/DD Accommodation Codes
(Regular Services)
Bedhold Accommodation Codes
Supplemental Payment Per Diem
ICF/DD
 41 (1-59 beds)
43
$15.47
ICF/DD
 41 (60+ beds)
43
$0.00
ICF/DD-H
 61 (4-6 beds)
63
$10.75
ICF/DD-H
 65 (7-15 beds)
68
$0.00
ICF/DD-N
 62 (4-6 beds)
64
$12.47
ICF/DD-N
 66 (7-15 beds)
69
$22.30
  • Note that facilities in peer groups in which the unfrozen 2017-18 65th percentile rate is lower than the current reimbursement rate will not receive the supplemental payment.     
  

2018.19 Intermediate Care Facilities Rates

The Department updated the 2018-19 reimbursement rates effective for dates of service on or after August 1, 2018.

2018.19 Comprehensive Rate List

Below is a comprehensive LTC rate list of the 2018-19 Rate, Supplemental Per Diem, and the total LTC reimbursement rates. The 2018-19 Rate includes the 3.7 percent rate increase, applicable add-ons, and the Quality Assurance Fee. 
Providers should continue to bill the 2018-19 Rate in accordance with the Medi-Cal Provider Manual. The respective peer group supplemental payment amount will be automatically added to the claim payment by our Fiscal Intermediary, Conduent State Healthcare, LLC, for every claim that is billed for dates of service August 1, 2018 through July 31, 2019.

2018.19 Intermediate Care Facilities Rates

The Department updated the 2018-19 reimbursement rates effective for dates of service on or after August 1, 2018. 
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.   
·         2018-19 ICFDD Rates for 1-59 Beds (PDF)
·         2018-19 ICFDD Rates for 60+ Beds (PDF)
·         2018-19 ICFDD-H Rates for 4-6 Beds (PDF)
·         2018-19 ICFDD-H Rates for 7-15 Beds (PDF)
·         2018-19 ICFDD-N Rates for 4-6 Beds (PDF)
·         2018-19 ICFDD-N Rates for 7-15 Beds (PDF)

 Previous Intermediate Care Facility Rates

 

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Last modified on: 5/9/2019 2:29 PM