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The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Rate Studies

The Developmental Disabilities Supports Division of the Health Care Authority conducts independent rate studies including rate analysis and rate setting; and research and business analysis. Rate studies result in recommendations for reimbursement rates for the provision of services for individuals with intellectual and developmental disabilities receiving services through all four Home and Community Based Services Waivers; the Developmental Disabilities Waiver (DDW), Mi Via Waiver (MV), Medically Fragile Waiver (MF) and the Supports Waiver (SW.)  Rate studies are conducted in accordance with the Centers for Medicare and Medicaid Services (CMS) rules for rate setting methodology for 1915 c waivers.

 2023

HCBS Waivers Rate Recommendations.pdf

Mathematical Rate Study Example

Provider Capacity Assessment Presentation

Provider Capacity Assessment Report

Public Comments and DDSD Response

 


 

Current Rates

For each of the four Home and Community Based Services Waivers; the Developmental Disabilities Waiver (DDW), Mi Via Waiver (MV), Medically Fragile Waiver (MF) and the Supports Waiver (SW), rates of reimbursement for each service must be approved by Centers for Medicaid and Medicare Services.

Notice of Approval of Amendments 2003.01.2023.pdf

All approved rates are published by the Health Care Authority in Fee Schedules