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.
In response to the increased cost pressures incurred by facilities due to the COVID-19 Public Health Emergency (PHE), DHCS provided these facilities with a COVID-19 PHE temporary rate increase equal to 10 percent of their 2019-20 per diem rates for the duration of the PHE, as approved in State Plan Amendment 20-0024.
In accordance with Senate Bill 184 (Chapter 47, Statutes of 2022), which amended Welfare and Institutions Code § 14105.075, DHCS is establishing a hold harmless provision for dates of service after the declared end of the PHE in the approved State Plan Amendment 22-0061. The hold harmless provision will provide that after the last day of the PHE, facilities will receive the greater of:
- The unfrozen, cost-based rate as described above, or
- The total reimbursement rate in effect on the last day of the PHE, inclusive of the COVID-19 PHE temporary rate increase.
ICF/DD reimbursement shifted from an August to July rate year basis to a calendar rate year basis, effective January 1, 2024, as approved in State Plan Amendment 23-0032.
Please see the following All Plan Letter for requirements applying to MCPs:
- APL 26-012 Intermediate Care Facilities For Individuals With Developmental Disabilities – Long-Term Care Benefit Under Managed Care (Supersedes APL 24-011)
CY 2027 Rates
CY 2027 Rate Study
The document below contains the public review model for ICF-DD (H/N) CY 2027 rates in accordance with California Medicaid State Plan (Attachment 4.19-D)
CY 2027 Public Review Rate Studies contain preliminary modeling of calendar year (CY) 2027 facility rates and are provided for public review only. These drafts do not update the Medi-Cal rates on file and are not intended for payment purposes or any other use. Final CY 2027 rates may materially differ from those outlined in the Public Review Rate Studies based on changes or corrections to underlying data, changes necessary to obtain federal approval, and other updates deemed appropriate per DHCS’s discretion. Please see the disclaimers included at the beginning of each Public Review document for additional details.
DHCS encourages facilities to carefully review their relevant rate studies and verify the accuracy of their reported costs, particularly those that serve as the foundation for rate development (e.g., capital costs, labor costs, non-labor expenses, etc.).
DHCS requests any comments or feedback no later than October 16, 2026. For any questions or comments, please email LTCReimbursement@dhcs.ca.gov with the subject line “CY 2027 Rates Public Review Draft.”
CY 2026 Rates
CY 2026 Rate Study
The document below contains the final model for ICF-DD (H/N) CY 2026 rates in accordance with California Medicaid State Plan (Attachment 4.19-D).
CY 2026 Rates Policy Letter
ICF/DD Calendar Year 2026 Rates – Effective January 1, 2026 through December 31, 2026 (Published 10/31/2025)
| Facility Type | Value Code | Value Code Amount | Revenue Code | Total Reimbursement Per Diem | Value Code | Value Code Amount | Revenue Code | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 Beds | 24 | 41 | 0101 | $433.48 | 24 | 43 | 0180 | $423.53 |
| ICF/DD 60+ Beds | 24 | 42 | 0101 | $421.42 | 24 | 44 | 0180 | $411.47 |
| ICF/DD-H 4-6 Beds | 24 | 61 | 0101 | $424.66 | 24 | 63 | 0180 | $414.71 |
| ICF/DD-H 7-15 Beds | 24 | 65 | 0101 | $430.91 | 24 | 68 | 0180 | $420.96 |
| ICF/DD-N 4-6 Beds | 24 | 62 | 0101 | $451.20 | 24 | 64 | 0180 | $441.25 |
| ICF/DD-N 7-15 Beds | 24 | 66 | 0101 | $485.42 | 24 | 69 | 0180 | $475.47 |
Notes:
- Rate table updated in accordance with the LTC Claim Form and Code Conversion.
- The 2026 Calendar Year bed hold amount is $9.95.
- Managed Care organizations may refer to the Total Reimbursement and the Total Bed Hold Reimbursement amounts.
ICF/DD Calendar Year 2025 Rates – Effective January 1, 2025 through December 31, 2025
Published 12/30/2024
| Facility Type | Value Code | Value Code Amount | Revenue Code | Total Reimbursement Per Diem | Value Code | Value Code Amount | Revenue Code | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 Beds | 24 | 41 | 0101 | $383.31 | 24 | 43 | 0180 | $373.54 |
| ICF/DD 60+ Beds | 24 | 42 | 0101 | $421.42 | 24 | 44 | 0180 | $411.65 |
| ICF/DD-H 4-6 Beds | 24 | 61 | 0101 | $403.44 | 24 | 63 | 0180 | $393.67 |
| ICF/DD-H 7-15 Beds | 24 | 65 | 0101 | $392.18 | 24 | 68 | 0180 | $382.41 |
| ICF/DD-N 4-6 Beds | 24 | 62 | 0101 | $424.05 | 24 | 64 | 0180 | $414.28 |
| ICF/DD-N 7-15 Beds | 24 | 66 | 0101 | $477.62 | 24 | 69 | 0180 | $467.85 |
Notes:
- Rate table updated in accordance with the LTC Claim Form and Code Conversion.
- The 2025 Calendar Year bed hold amount is $9.77.
- Managed Care organizations may refer to the Total Reimbursement and the Total Bed Hold Reimbursement amounts.
ICF/DD Calendar Year 2024 Rates – Effective February 1, 2024 through December 31, 2024
| Facility Type | Value Code | Value Code Amount | Revenue Code | Total Reimbursement Per Diem | Value Code | Value Code Amount | Revenue Code | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|---|---|---|---|
| ICF/DD 1-59 Beds | 24 | 41 | 0101 | $369.73 | 24 | 43 | 0180 | $360.21 |
| ICF/DD 60+ Beds | 24 | 42 | 0101 | $421.42 | 24 | 44 | 0180 | $411.90 |
| ICF/DD-H 4-6 Beds | 24 | 61 | 0101 | $363.12 | 24 | 63 | 0180 | $353.60 |
| ICF/DD-H 7-15 Beds | 24 | 65 | 0101 | $378.14 | 24 | 68 | 0180 | $368.62 |
| ICF/DD-N 4-6 Beds | 24 | 62 | 0101 | $394.48 | 24 | 64 | 0180 | $384.96 |
| ICF/DD-N 7-15 Beds | 24 | 66 | 0101 | $445.65 | 24 | 69 | 0180 | $436.13 |
Notes:
- Rate table updated in accordance with the LTC Claim Form and Code Conversion.
- The 2024 Calendar Year bed hold amount is $9.52.
- Managed Care organizations may refer to the Total Reimbursement and the Total Bed Hold Reimbursement amounts.
ICF/DD Calendar Year 2024 Rates – Effective January 1, 2024 through January 31, 2024
| Facility Type | Regular Accommodation Code | Total Reimbursement Per Diem | Bed Hold Accommodation Code | Total Bed Hold Reimbursement Per Diem |
|---|---|---|---|---|
| ICF/DD 1-59 Beds | 41 | $369.73 | 43 | $360.21 |
| ICF/DD 60+ Beds | 41 | $421.42 | 43 | $411.90 |
| ICF/DD-H 4-6 Beds | 61 | $363.12 | 63 | $353.60 |
| ICF/DD-H 7-15 Beds | 65 | $378.14 | 68 | $368.62 |
| ICF/DD-N 4-6 Beds | 62 | $394.48 | 64 | $384.96 |
| ICF/DD-N 7-15 Beds | 66 | $445.65 | 69 | $436.13 |
Notes:
- The 2024 Calendar Year bed hold amount is $9.52.
- Managed Care organizations may refer to the Total Reimbursement and the Total Bed Hold Reimbursement amounts.
Contact Us
Please send questions regarding ICF/DD rates to LTCReimbursement@dhcs.ca.gov.