SCDHHS issued Medicaid Bulletin MB# 26-044 on October 30, 2026, announcing rate increases for several state plan and HCBS 1915(c) waiver services. The new rates apply to dates of service on or after December 1, 2026. Claims for earlier dates of service are processed at the rate in effect on those dates.
The numbers
Residential Habilitation (ID/RD and HASCI waivers), by support level
The code is the same (T2016) at every level. The modifier (U1 to U8) tells SCDHHS which level is being billed, so a wrong modifier means a wrong rate. The Residential Review Committee assigns each participant's level.
| Level and modifier | Who it serves and where | Unit | Current | New | Change (our calculation) |
|---|---|---|---|---|---|
| U8 High Management (3-person home) | Intensive support in a Community Training Home II shared by up to 3 people with extremely challenging behaviors. The ID/RD manual says dual diagnosis or extremely challenging behaviors; the HASCI manual adds brain injury, spinal cord injury or a similar disability. | Per day | $536.86 | $552.09 | ~2.8% |
| U7 Tier 4 (4-person home) | Intensive support in a Community Training Home II shared by up to 4 people, including people with criminal justice involvement and severe behaviors that need heightened staffing. The fee schedule labels this level "forensic"; the manuals do not use that word. | Per day | $536.86 | $552.09 | ~2.8% |
| U6 Tier 3 (4-person home) | Intensive support in a Community Training Home II (up to 4 people) or a CRCF (up to 12). Includes people leaving an ICF/IID and people who need extra support to avoid institutional placement. | Per day | $386.55 | $397.46 | ~2.8% |
| U5 Tier 2 (4-person home) | Community Training Home II (up to 4) or CRCF (up to 12), for people who need more support than Tier 1. | Per day | $329.61 | $338.88 | ~2.8% |
| U4 Tier 1 (4-person home) | Community Training Home II (up to 4) or CRCF (up to 12), for people who need support to live in and take part in their community. | Per day | $278.77 | $286.58 | ~2.8% |
| U3 Supervised Living Program II (SLP II) | A licensed SLP II setting, typically a single or double-occupancy residence, with care, supervision and skills training throughout the day. | Per day | $108.78 | $111.69 | ~2.7% |
| U2 Community Training Home Tier 2 | Up to 3 people in the licensed home of the support provider (CTH I), for people who need supports beyond CTH Tier 1. | Per day | $125.62 | $127.82 | ~1.8% |
| U1 Community Training Home Tier 1 | Up to 3 people in the licensed home of the support provider (CTH I). | Per day | $91.76 | $93.28 | ~1.7% |
| T2017 (no modifier) Supported Living Program I (SLP I) | People in their own apartment or home. Support is billed in 15-minute units, is available by phone 24 hours a day, and is reassessed annually. | Per 15 minutes | $21.49 | $22.06 | ~2.7% |
Abbreviations: CTH = Community Training Home; SLP I = Supported Living Program I, SLP II = Supervised Living Program II; CRCF = Community Residential Care Facility; ICF/IID = Intermediate Care Facility for Individuals with Intellectual Disabilities. SCDHHS lists U8 and U7 together at one rate. Level descriptions come from the OIDD ID/RD Waiver manual (Chapter 10, rev. 03/2023) and the HASCI Waiver manual (rev. Nov. 2025); the rates and unit labels come from the SCDHHS fee schedule and the bulletin.
Other HCBS waiver services
| Service | Code | Waivers | Current | New | Change (our calculation) |
|---|---|---|---|---|---|
| Personal care | T1019 | CC, CS, HIV/AIDS, ID/RD, VENT | $25/hr | $26/hr | ~4.0% |
| Nursing services | S9123 | HASCI, HIV/AIDS, ID/RD, VENT | $47/hr | $48/hr | ~2.1% |
Waiver abbreviations: CC = Community Choices; CS = Community Supports; HIV/AIDS = HIV/AIDS Waiver; ID/RD = Intellectual Disability/Related Disabilities; VENT = Mechanical Ventilator; HASCI = Head and Spinal Cord Injury.
State plan rates (not waiver services)
| Service | Code | Current | New | Change (our calculation) |
|---|---|---|---|---|
| Children's personal care | T1019 | $25/hr | $26/hr | ~4.0% |
| Enhanced nursing | T1002 | $50/hr | $51/hr | ~2.0% |
| Nursing services | S9123 | $47/hr | $48/hr | ~2.1% |
SCDHHS lists current and new rates; the percentages in the Change column are our own calculation from those figures.
What to do before December 1
- Update your billing system and fee schedule. SCDHHS expects billing systems and the HCBS Waiver Fee Schedule to reflect the new rates by December 1. Confirm your clearinghouse or billing vendor has loaded them rather than assuming.
- Re-run your residential budget by support level. The increase is not uniform: U4 through U8 rise about 2.8%, SLP II (U3) and SLP I (T2017) about 2.7%, and the two Community Training Home levels (U2 and U1) rise under 2%. A provider whose participants are mostly in Community Training Homes will see less lift than one serving the 4-person tiers.
- Compare the increase to your actual cost growth. A 2.7 to 2.8% rate change is useful but small next to wage pressure on direct support staff. Treat the increase as a reason to re-check wage and overtime assumptions, not as a margin windfall.
- Plan the date-of-service split. Any service period crossing December 1 will be billed at two rates. Make sure your timekeeping and claims workflow can split cleanly at month boundaries.
Questions on the bulletin go to MedicaidWaiver@scdhhs.gov.
Level descriptions re-checked against the OIDD manuals on November 2, 2026.
Last verified against the linked agency source on October 30, 2026. Regulatory details change; confirm before acting.
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