MedicaidReimbursementMedium impact
IL 2740-MC-FFS: 2740 SFY27 Home and Community-Based Services (HCBS) Waiver Rate Changes
Iowa Medicaid·IA · Geriatrics, Occupational Therapy·Claims & Billing
Effective date
Oct 1, 2026
We identified it
Sep 15, 2026
Summary
Iowa Medicaid is increasing reimbursement rates for four specific HCBS Waiver services (Assisted Living, Attendant Care–Unskilled, Attendant Care–Skilled, and Home Maintenance Support) effective October 1, 2026. Billing teams must verify updated fee schedules and ensure claims are submitted using the correct billing codes (T2031, S5125, S5125 U3, S5130) to capture the new higher rates.
Action Required
By September 30, 2026: Billing team must access the Iowa Medicaid Fee Schedules webpage under the HCBS heading to obtain the updated reimbursement rates for codes T2031, S5125, S5125 U3, and S5130. Update billing system fee schedules and claim submission settings to reflect the new rates effective October 1, 2026. Verify that claims for Assisted Living (Elderly), Attendant Care (Unskilled and Skilled), and Home Maintenance Support services submitted on or after October 1 are billed at the increased rates. Contact Iowa Medicaid Provider Services (1-800-338-7909 or imeproviderservices@hhs.iowa.gov) or the appropriate MCO if new rate amounts are not accessible or if claims are denied at the previous rate amounts.