Reimbursement Rates
A listing of services and rates appears below. Note, providers can only bill for Medi-Cal services provided to enrolled clients.
Care Coordination: $200/participant/month
Nursing Facility Transition Care Coordination: $1,000/participant
Assisted Living Bundle:
Tier 1 -- $52/participant/day
Tier 2 -- $62/participant/day
Tier 3 -- $71/participant/day
Tier 4 -- $82/participant/day
Assisted Care:
Tier 1 -- $52/participant/day
Tier 2 -- $62/participant/day
Tier 3 -- $71/participant/day
Tier 4 -- $82/participant/day
Community Transition: $2,500/participant (only for participants transferring from nursing facility to the community)
Environmental Accessibility Adaptations: $1,500/participant
Consumer Education: $22/hour (consumers are limited to 10 hours in their initial year of enrollment)
Interpretation and Translation: $59/hour (consumers are limited to 4 hours/year)
Room and Board: ALWPP providers receive room or rent payments from ALWPP waiver participants. The current room and board rate is $936 per month (based on $1055 for Supplemental Security Income (SSI)/State Supplemental Payment (SSP) payments less $119 for the personal needs allowance). RCFEs receive service payment at the assessed tier plus the $936 room and board payment. Public housing providers receive the payment in ALWPP settings where participants receive assisted living services from a home health agency and live in a public housing residence.
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