Iowa Medicaid raised several HCBS waiver fee-schedule rates on Oct. 1, 2026, including attendant care billed on the Intellectual Disability waiver.
Informational Letter 2740-MC-FFS, dated Sept. 14, 2026, implements a $3 million appropriation in 2026 House File 2782 for services used heavily on the Elderly Waiver and shared across other waivers. Unskilled attendant care (S5125) is now $6.69 per 15 minutes; skilled attendant care (S5125 U3) is $7.23. Those codes apply on the AIDS/HIV, Brain Injury, Elderly, Health and Disability, Intellectual Disability, and Physical Disability waivers. Home maintenance support (S5130) is $6.55 per 15 minutes on AIDS/HIV, Elderly, and Health and Disability. Elderly Waiver assisted living (T2031) is $31.43 per day.
The implementation guide raises monthly caps on the total cost of services for several waivers by 12.2% so existing authorizations can absorb the higher unit rates. A separate fee-schedule sheet lists a $156.16 daily limit for attendant care. Iowa plans a uniform fee schedule for all HCBS waiver and habilitation services on Jan. 1, 2027, keeping these Table A rates in place at that step. Consumer Choice Option rates are not changed by this appropriation.
Why this matters for providers and DSPs
Agencies and self-directed employers billing S5125 on Iowa’s ID and other waivers should update claims systems for dates of service on or after Oct. 1 and confirm MCO fee schedules match the state letter. The bump is modest per unit; whether it reaches DSP or attendant paychecks depends on each provider’s wage policy and any pass-through rules in managed-care contracts.