Medicaid CDPAS Rates
- Rates are also available in (PDF)
New York State Department of Health
Medicaid CDPAS Rates – Effective January 01, 2023
Agency:
MMIS ID: xxxxxxxx
Locator Code: xxx
County:
Region:
| Rate Components | Consumer Directed Services | |||
|---|---|---|---|---|
| Consumer Directed | Consumer Directed Enhanced | Consumer Directed Live-in | ||
| Direct Care and Training | ||||
| (1) | Direct Care & Training Costs | |||
| (2) | Direct Care & Training Regional Ceiling (capped at 115% of regional average) | |||
| (3) | Direct Care & Training Rate (Lower of Direct Care & Training Costs or Regional Ceiling) [Lower of (1) or (2)] | $0.00 | $0.00 | $0.00 |
| Capital and Background & Fingerprinting Costs | ||||
| (4) | Capital Costs | |||
| (5) | Background & Fingerprinting Costs | |||
| (6) | Total Capital and Background & Fingerprinting Costs [(4) + (5)] | $0.00 | $0.00 | $0.00 |
| (7) | Direct Care & Training Rate and Capital and Background & Fingerprinting Costs [(3) + (6)] | $0.00 | $0.00 | $0.00 |
| Rate Add-Ons | ||||
| (8) | Profit / Surplus | |||
| (9) | Total Rate [(7) + (8)] | $0.00 | $0.00 | $0.00 |
| (10) | Public Charge Rate | |||
| (11) | Lower of Total Rate or Public Charge Rate (if > $0) | |||
| (12) | Minimum Wage | |||
| (13) | Worker Recruitment & Retention [(11) + (12)]*4.56% | |||
| (14) | 1% Medicaid ATB Increase (eff. 4/1/2022) [(15) + (16) + (17)] * 1% | |||
| (15) | Final Rate [(11) + (12) + (13)]+ (14)] | |||
| One Client | $0.00 | $0.00 | $0.00 | |
| Two Clients | $0.00 | $0.00 | $0.00 | |
| One Client 1/4 hour | $0.00 | $0.00 | ||
| Two Clients 1/4 hour | $0.00 | $0.00 | ||
Supporting Calculation for Medicaid CDPAS Rates Effective January 01, 2023
Agency:
MMIS ID: xxxxxxxx
Locator Code: xxx
County:
Region:
| Rate Components | Consumer Directed Services | |||||||
|---|---|---|---|---|---|---|---|---|
| Consumer Directed | Consumer Directed Enhanced | Consumer Directed Live-in | ||||||
| 1. Direct Care & Training Costs | ||||||||
| (1) | Direct Care & Training cost by service (Sch 3c col 005 & 007-010) | |||||||
| (2) | Hours/Visits by service (Sch 5c col 023 or 024)) | |||||||
| (3) | Direct Care & Training cost per hour/visit | $0.00 | $0.00 | $0.00 | ||||
| 2. Admin Cost (excluding Capital and Background & Fingerprinting) | ||||||||
| (1) | Program admin cost by service (Sch 3c col 004) | |||||||
| (2) | Total program admin cost across Sch 3c (Sch 3c col 004 line 007) | |||||||
| (3) | Admin Percent [(1) / (2)] | |||||||
| (4) | Hours/Visits by service (Sch 5c col 023 or col 024) | |||||||
| (5) | Admin Cost per hour/visit [(1) / (4)] | NA* | ||||||
| (6) | Capital Cost across Sch 4c (Sch 4c total of col 004 lines 002-003 & 005-011 & 015) | |||||||
| (7) | Capital Cost per hour/visit by service [(3) * (6) / (4)] | |||||||
| (8) | Background & Fingerprinting across Sch 4c (Sch 4c col 003 line 001) | |||||||
| (9) | Background & Fingerprinting Cost per hour/visit by service [(3) * (8) / (4)] | |||||||
| (10) | Admin Cost (excluding Capital and Background & Fingerprinting) [(5) - (7) - (9)] | NA | ||||||
| * Outside of Capital Cost and Background & Fingerprinting, admin reimbursement for FIs occurs separately through a tiered utilization approach. | ||||||||
| 3. Profit / Surplus Add-On | ||||||||
| (1) | Admin and Direct Care & Training Rate | |||||||
| (2) | Allowable costs for aide wages and benefits across Sch 3c (Sch 3c col 005 & col 008-010) | |||||||
| (3) | Total Allowable cost across Sch 3c (Sch 3c col 003) | |||||||
| (4) | 6 Months T-Bill rate (As on 30 Sept 2022) | |||||||
| (5) | Profit / Surplus Percentage Adjustment [(2) / (3) * (4)] | |||||||
| (6) | Profit / Surplus Add-On [(5) / (1 − (5)) * (1)] | $0.00 | $0.00 | $0.00 | ||||
| 4. Public Charge Rate | ||||||||
| (1) | Public Charge Rate (Sch 7c col 001) | |||||||
| 5. Minimum Wage Adjustment | ||||||||
| 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | ||
| (1) | Base Rate Increase | |||||||
| Downstate | $1.50 | $1.50 | $1.00 | $1.00 | $1.00 | $1.00 | $0.00 | |
| Upstate | $2.50 | $1.20 | $0.70 | $0.70 | $0.70 | $0.70 | $0.70 | |
| (2) | Fringe Benefits | |||||||
| Downstate | $0.26 | $0.26 | $0.18 | $0.18 | $0.18 | $0.28 | $0.00 | |
| Upstate | $0.43 | $0.21 | $0.12 | $0.12 | $0.12 | $0.20 | $0.20 | |
| (3) | Fringe Benefits | |||||||
| Downstate (Base Rate + Fringe Benefits) | $1.76 | $1.76 | $1.18 | $1.18 | $1.18 | $1.28 | $0.00 | |
| Upstate (Base Rate + Fringe Benefits) | $2.93 | $1.41 | $0.82 | $0.82 | $0.82 | $0.90 | $0.90 | |
| 2023 MW Adjustment | Live-in (13 hours) |
Other CDPAS Services | ||||||
| Downstate | $108.33 | $8.33 | ||||||
| Upstate | $111.73 | $8.59 | ||||||
