Minimum Fee Schedule Information

New Minimum Fee Schedule for Home and Community-Based Services

The Wisconsin Department of Health Services (DHS) has created a minimum fee schedule (MFS) for home and community-based services (HCBS) in Wisconsin. The minimum fee schedule is a list of the minimum rates Managed Care Organizations (MCO) can pay providers of certain adult long-term care services. This applies to:

• Supportive home care services
  • Agency
  • Member self-directed
• Residential facilities
  • 1-2 bed adult family homes (AFHs)–owner occupied and corporate owned
  • 3-4 bed AFHs
  • Residential care apartment complexes (RCACs)
  • Community based residential facilities (CBRFs)

MCOs must follow the minimum fee schedule beginning October 1, 2024.

Resources

• Minimum Fee Schedule for Home and Community-Based Services (wi.gov) : DHS website for Minimum Fee Schedule.
  • Includes the following resources:
    • Frequently Asked Questions
    • HCBS Minimum Fee Schedule Webinar Recording (held September 13, 2024)
    • HCBS Minimum Fee Schedule Webinar PowerPoint slides
• Minimum Fee Schedule FAQs iCare-Inclusa
• Minimum Fee Schedule Information by Service Type:
  • Fiscal Agents – Self Directed Supports
  • Supportive Home Care Agencies Providing Quarter Hour Attendant, Companion Care, and Chore Services
  • Supportive Home Care and Community Supported Living Agencies Providing SHC Daily Rate Attendant and Companion Care Services
  • Residential Providers including AFH, CBRF, and RCAC
• Claims and Billing:
  • • Minimum Fee Schedule iCare Family Care Billing Guide
    • Residential Claim Submission Tip Sheet

Contacts

• Provider Implementation Questions: WIMarketMFS@humana.com
• Provider Billing Questions: ACS-Residential-CSL-NH@inclusa.org or ACS-SHC-SDS-HomeHealth@inclusa.org