MedicaidReimbursementHigh impact
Jan. 1, 2026, PCA and CFSS reimbursement rates and wage floor retroactive payment requirements
Minnesota Medicaid (MHCP)·MN · Occupational Therapy, Physical Therapy·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 1, 2026
Summary
Minnesota DHS has implemented new tiered minimum wage floors for Personal Care Assistance (PCA) and Community First Services and Supports (CFSS) direct support workers, effective Jan. 1, 2026, with retroactive payment requirements. Providers must pay workers the enhanced minimum wages for all hours worked from Jan. 1, 2026 forward, and must make retroactive payments for hours already worked. New wage floor tiers were distributed to PCA Choice and FMS providers on May 28, 2026.
Action Required
By June 30, 2026: PCA Choice agencies and FMS providers must audit payroll records for all direct support workers serving members in PCA Choice and CFSS budget models for hours worked on or after Jan. 1, 2026. Calculate retroactive wage adjustments based on the tiered minimum wage floors provided in the May 28, 2026 memo (NPI/UMPI_PRVLTR_20260528_Tiered_minimum_wage_floors_for_PCA_and_CFSS_workers.pdf) located in provider MN-ITS mailbox PRVLTR folder. Process retroactive payments immediately to workers for the wage differential between what was paid and the new minimum wage floors. Update payroll systems and labor cost projections to reflect the new tiered wage requirements for ongoing hours. Verify that all claims submitted for PCA and CFSS services from Jan. 1, 2026 forward reflect the enhanced reimbursement rates approved by the federal government. Failure to comply with retroactive wage payment requirements may result in compliance violations and potential recoupment actions by Minnesota DHS.